Clozapine treatment for schizophrenia-related polydipsia

Diniz, Juliana Belo; Cordeiro, Quirino; Zung, Stevin

doi:10.1590/s1516-44462010000300019

Cited by 8 publications

(4 citation statements)

References 3 publications

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“…It emphasizes its low rate of extrapyramidal effects and its antipsychotic potency, being currently indicated in the management of resistant psychosis and psychotic symptoms in Parkinson's disease. Literature collects controversial data on its relationship with hyponatremia, although some authors defend its use in Syndrome of Psychosis, Intermittent Hyponatremia and Polydipsia (PIP syndrome) [37].…”

Section: Clozapinementioning

confidence: 99%

“…Some studies show that urine concentration measurements are useful to differentiate both situations, detecting more frequently concentrated urine in pharmacological hyponatremia and dilute urine secondary to psychotic decompensation [39]. While some studies show that clozapine can generate polydipsia and hyponatremia, others show that it improves the symptoms of polydipsia, so clozapine is postulated as a therapeutic option [37], especially as an alternative to electroconvulsive therapy in cases of catatonia [40].…”

Section: Syndrome Of Psychosis Intermittent Hyponatremia and Polydipmentioning

confidence: 99%

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Hyponatremia and Psychotropic Drugs

Cortés¹,

Muñoz²

2019

Fluid and Electrolyte Disorders

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Given the widespread use of psychotropic drugs in the population, it's important to consider hyponatremia as an avoidable and reversible adverse effect and include the detection of high-risk subjects to establish safer medications, as well as early detection measures in routine clinical practice. Although hyponatremia has been especially associated with serotonergic antidepressants (SSRIs), there is also an elevated risk with tricyclics, duals and heterocyclic antidepressants, due to the different mechanisms of action at the renal tubular level and the release of ADH. Hyponatremia secondary to tricyclics with slow CYP2D6 metabolizers have higher plasma concentrations of antidepressants metabolized by CYP2D6. Hyponatremia secondary to SSRIs appears in the first week of treatment, it is "not dose-dependent" and normalization of natremia occurs between 2 and 20 days after stopping the medication. Bupropion, trazodone, mianserin, reboxetine and agomelatine are a safe alternative. Also antiepileptics have been related to hyponatremia. Both typical and atypical antipsychotics have been exposed to an increased risk of hyponatremia, even after adjusted factors such as age, sex and comorbidity. Other factors that favor the onset of hyponatremia act synergistically with psychotropic drugs, such as: advanced age, female sex, concomitant diuretic intake, low body weight and low sodium levels; NSAID, ACEIs, and warm.

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Section: Clozapinementioning

confidence: 99%

Section: Syndrome Of Psychosis Intermittent Hyponatremia and Polydipmentioning

confidence: 99%

Hyponatremia and Psychotropic Drugs

Cortés¹,

Muñoz²

2019

Fluid and Electrolyte Disorders

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“…Due to the unclear mechanism and pathophysiology, very few controlled clinical studies have been done. 5 There are few treatment options and the evidence on their efficacy is weak and conflicting. 1,6 There have been conflicting reports on the use of Clozapine in patients with schizophrenia and psychogenic polydipsia.…”

Section: Introductionmentioning

confidence: 99%

“…There are some reports which show that Clozapine can cause polydipsia and hyponatremia 7 while other reports have shown that Clozapine can ameliorate symptoms of polydipsia. 5,[8][9][10] We report a unique case of a 53 year old Caucasian man with past history of chronic schizophrenia and multiple past psychiatric hospitalizations. Patient presented with extreme stupor, mutism and polydipsia which was successfully treated with clozapine.…”

Section: Introductionmentioning

confidence: 99%

Treatment of Catatonic Schizophrenia and Psychogenic Polydipsia with Clozapine: A Case Report

Virk¹

2016

MOJAMT

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Psychogenic polydipsia is a common problem in patients with chronic schizophrenia with prevalence rates varying from 5%-10%. No definitive treatment guidelines exist for pharmacological treatment of psychogenic polydipsia. There have been conflicting reports on antipsychotics causing and being used for treatment of polydipsia. We report a unique case of a 53 year old patient presenting with schizophrenia with catatonic features and psychogenic polydipsia treated with Clozapine. Dramatic improvement was seen not only in the polydipsia and correction of hyponatremia but also in catatonic behavior within few weeks. Clozapine may be a possible alternative option for patients presenting with catatonia and psychogenic polydipsia especially in settings where there is no availability for Electroconvulsive therapy (ECT). Keywords

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