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Captopril alters schedule induced polydipsia, urination, and defecation in rats.

Schedule induced polydipsia, urination and defecation were examined in rats that received training on a fixed interval 2 min schedule of food reinforcement. In Phase I of the experiment, animals received peripheral injections of captopril (an angiotensin conversion enzyme blocker, 0.5 or 50 mg/kg), or equivalent volumes of 0.9% saline. The results showed that low doses of captopril (0.5 mg/kg) significantly increased both operant responding and the adjunctive behaviors. High peripheral doses of captopril significantly reduced responding and schedule induced behavior. In Phase II of the experiment, animals received either low peripheral doses of captopril (sc 0.5 mg/kg), or low doses that were coupled with central injections (i.e., 0.12 mg icv + 0.5 mg/kg sc). As observed in Phase I, low peripheral doses of captopril enhanced behavior, but the enhancement effect was eliminated with low (0.12 mg) central administration. The overall results are consistent with past research examining captopril effects on non-operant, meal-induced drinking. Yet since captopril affected operant responding and adjunctive behaviors similarly, the findings suggest that angiotensin plays a common role in the motivational processes that precede and follow the arrival of food.

Analysis of Variance↗

Roles of arginine vasopressin and atrial natriuretic peptide in polydipsia-hyponatremia of schizophrenic patients.

Respective contributions of arginine vasopressin (AVP) and atrial natriuretic peptide (ANP) to the urinary sodium concentration were evaluated in 23 naturalistic incidents of polydipsia-hyponatremia observed in 11 hospitalized schizophrenics (10 males and 1 female). The sodium concentration of the spontaneously excreted urine was examined before and after the forced water restriction. Before the water restriction, mean (+/-S.D.) plasma ANP was 52.8 +/- 33.9 pg/ml (range = 6.9-137). Plasma AVP levels were below 0.3 pg/ml in 15 episodes; relatively high levels (> or = 0.3) were noted in eight episodes. Means of urinary sodium concentration (mEq/l) were significantly higher in episodes with high AVP (> or = 0.3) alone (25.0 +/- 8.2, n=4), with high ANP (> 43) alone (21.3+/-7.4, n = 9), and with high AVP and ANP (26.8 +/- 6.4, n = 4) as compared to that of the low AVP (< 0.3) and ANP (< or = 43) group (13.5 +/- 3.7, n = 6). The data indicate that the elevated urinary sodium in polydipsic patients is possibly due to the AVP-induced antidiuresis and/or the ANP-induced natriuresis. In addition, we observed a close relationship between elevated plasma AVP and vomiting, suggesting that vomiting is one of the causal factors responsible for AVP elevations in this syndrome.

Adult↗

Amphetamine reinstates polydipsia induced by chronic exposure to quinpirole, a dopaminergic D2 agonist, in rats.

The hypothesis that the combined activation of D1 and D2 dopaminergic receptors is instrumental in inducing amphetamine (AMPH)-mediated hyperdipsia was tested in rats. The D1 agonist SKF-38393 (SKF) and the D2 agonist quinpirole (QNP) were i.p. injected, alone or in combination, to male rats for 10 days. After 2 days of wash-out, a single dose of AMPH (3 mg/kg) was administered. Intake of water and food and diuresis were daily measured at 2, 5 and 24 h. In two further experiments the higher dose of QNP (0.56 mg/kg) was given with two different doses of the D1 antagonist SCH-23390 (SCH), or, respectively, of the peripheral D2 antagonist domperidone (DMP). In a fourth experiment, the possibility that QNP, given alone or in combination with SKF, produces an AMPH-like internal state was evaluated by using a drug-discrimination paradigm. Results show that chronic administration of QNP produced a significant increase of 24 h water intake that was reinstated by AMPH. This QNP effect was only partially prevented by DMP, suggesting a main central mechanism of action. By itself D1 receptor manipulation did not affect water intake, but influenced QNP polydipsia that, accordingly, was enhanced by the lower dose of SKF (0.3 mg/kg) and inhibited by the lower dose of SCH (0.01 mg/kg). In rats trained to discriminate AMPH from solvent, QNP partially generalized for the AMPH stimulus, an effect that was potentiated by SKF. In conclusion, a D1-modulated sensitization of D2 dopaminergic mechanisms is probably involved in AMPH-induced hyperdipsia.

Amphetamine↗

A novel behavioral paradigm for assessing tinnitus using schedule-induced polydipsia avoidance conditioning (SIP-AC).

A behavioral technique was developed that allowed the onset and recovery of tinnitus to be measured in individual rats treated with different doses of salicylate. Food-restricted rats were self-trained to lick for water during the time between scheduled delivery of food pellets, i.e., schedule-induced polydipsia (SIP). SIP-induced licking was placed under stimulus control by administering foot shock if licks occurred when sound (one of six stimuli, 40 dB SPL) was present; rats were allowed to lick during quiet. After the number of licks-in-quiet (correct response) exceeded 90% of total licks, rats were treated with saline and four different doses of salicylate (50, 100, 150 and 350 mg/kg, intraperitoneally (i.p.); 2 days). Performance was assessed before, during and after treatment. Licks-in-sound remained extremely low with saline and all four salicylate doses indicating that the sounds were audible under all treatment conditions. Licks-in-quiet remained high during the saline control and 50 mg/kg dose of salicylate, behavior consistent with the absence of tinnitus. However, licks-in-quiet showed a statistically significant decline with the 150 and 350 mg/kg dose, behavior consistent with the presence of tinnitus. Licks-in-quiet gradually recovered to baseline level 2-3 days following high-dose salicylate treatments, behavior consistent with the gradual disappearance of tinnitus. The salicylate dose needed to induce tinnitus and the length of recovery are consistent with previous reports, providing support for the method. The ability to obtain sequential estimates of tinnitus-like behavior in an animal after administering a tinnitus-inducing agent could aid in understanding the underlying neural mechanisms and assessing potential treatments.

Animals↗

Polydipsia in chronic psychiatric patients: therapeutic trials of clonidine and enalapril.

A six month long double-blind, placebo-controlled, crossover design pharmacological study was conducted on 14 chronically psychotic, institutionalized patients who suffered from chronic water abuse ("psychogenic polydipsia"). Effects of clonidine and enalapril administered separately and individually were assessed for possible beneficial effects on both physiological parameters such as diurnal weight gain, urine output, and serum sodium levels and on signs of delirium as measured by neurobehavioral testing. Improvement, particularly in tests reflecting fluid consumption, was found with either or both drugs in approximately 60% of test subjects, although no behavioral improvement was demonstrated. As a result of evidence for delayed and carry-over effects the authors recommend that future studies employ phases longer than one month and/or include washout periods.

Adult↗

Temporal stability of polydipsia-hyponatremia.

We evaluated temporal stability and outcome predictors associated with polydipsia-hyponatremia (PH). Severity of PH was measured on two occasions separated by at least 1 year in 25 chronic psychiatric inpatients (24 with schizophrenia). Three-quarters of the sample had clinically evident PH on follow-up. Follow-up PH severity was significantly related to intake severity and hospitalization length. Our findings suggest that PH may be a persistent condition with specific outcome predictors.

Adult↗

Diabetes insipidus and polydipsia in a patient with Asperger's disorder and an empty sella: a case report.

The paper describes a patient with Asperger disorder, Neurogenic Diabetes Insipidus (NDI) and Primary Empty Sella (ES). His response to vasopressin treatment suggested a concomitant presence of primary polydipsia. This is the first reported case of an autistic spectrum disorder associated with NDI or ES. The implications of the observed co-occurrence of these relatively rare disorders are discussed in relation to diagnosis and pathogenesis.

Adult↗

Role of the pituitary-adrenal hormones in the acquisition of schedule-induced polydipsia.

Adrenalectomized female rats failed to develop schedule-induced polydipsia (SIP). Dexamethasone (DEX) injections failed to reinstate SIP in adrenalectomized rats. They did not prevent intact rats from acquiring SIP but interfered with subsequent expression of this behavior. In contrast, corticosterone, the rats' normally occurring glucocorticoid, fully restored the acquisition and subsequent expression of SIP in adrenalectomized rats. This strongly suggests that corticosterone plays an essential role in the normal acquisition and development of this behavior. Data are interpreted in the context of current information concerning adrenal hormone receptors. It is hypothesized SIP acquisition is at least partly regulated by the Type I (mineralocorticoid) receptor.

Adrenalectomy↗

Schedule-induced polydipsia in rats: adrenocortical and hippocampal modulation.

Onset of schedule-induced polydipsia (SIP) is related to adrenal gland weight. Adrenalectomy, but not demedullation, hastened the emergence of SIP, and exogenous corticosterone administration tended to reverse this effect. Hippocampal lesions were followed by a rapid and uniform release of SIP. None of the above manipulations influenced normal (home-cage) drinking. A synthesis of present findings with the literature suggests that the hippocampus and the adrenal cortex interact and that the equilibrium established within this system is reflected, for any particular rat, in its adjunctive behavior.

Adrenal Cortex↗

Schedule-induced polydipsia suppresses pituitary-adrenal activity in rats.

The effects of schedule-induced polydipsia (SIP) on pituitary-adrenal activity, as indicated by plasma levels of corticosterone, were examined in a series of experiments. Male (Experiments 1 and 3) and female (Experiment 2) rats were reduced to 80% of their free-feeding weight and given daily sessions on an intermittent-feeding schedule (fixed time of 60 sec). Half of the subjects in each experiment had water available during experimental sessions and the other half did not. Animals with water available in the experimental chamber exhibited SIP in all three experiments. In Experiment 1, blood samples were collected following (a) food consumption in the home cage, (b) a session on FT 60 sec, and (c) a session with pellets available in a cup in the experimental chamber. In Experiment 2, blood samples were taken prior to and following an FT 60-sec session, and following a session with pellets available in a cup in the chamber. In Experiment 3, pre- and postsession samples were obtained as in Experiment 2 (Part A). Subsequently, the opportunity to drink during sessions was removed, and the effect on corticoids was examined (Part B). The results indicate that (a) schedule-induced drinking suppresses pituitary-adrenal activity, (b) corticoid suppression may become a conditioned response to drinking in the chamber, and (c) corticoids return to presession levels following removal of water from the chamber. In view of these findings, it is hypothesized that SIP may serve an arousal-reducing role in intermittent-feeding situations.

Animals↗

Polydipsia: a feature of peritoneal dialysis.

BACKGROUND: Some dialysis patients fail to comply with their fluid restriction causing problems due to volume overload. These patients sometimes blame excessive thirst. There has been little work in this area and no work documenting polydipsia among peritoneal dialysis (PD) patients. METHODS: We measured motivation to drink and fluid consumption in 46 haemodialysis patients (HD), 39 PD patients and 42 healthy controls (HC) using a modified palmtop computer to collect visual analogue scores at hourly intervals. RESULTS: Mean thirst scores were markedly depressed on the dialysis day (day 1) for HD (P<0.0001). The profile for day 2 was similar to that of HC. PD generated consistently higher scores than HD day 1 and HC (P = 0.01 vs. HC and P<0.0001 vs HD day 1). Reported mean daily water consumption was similar for HD and PD with both significantly less than HC (P<0.001 for both). However, measured fluid losses were similar for PD and HC whilst HD were lower (P<0.001 for both) suggesting that the PD group may have underestimated their fluid intake. CONCLUSION: Our results indicate that HD causes a protracted period of reduced thirst but that the population's thirst perception is similar to HC on the interdialytic day despite a reduced fluid intake. In contrast, the PD group recorded high thirst scores throughout the day and were apparently less compliant with their fluid restriction. This is potentially important because the volume status of PD patients influences their survival.

Adult↗

Multidisciplinary approach to psychosis, intermittent hyponatremia, and polydipsia.

The syndrome of psychosis, intermittent hyponatremia, and polydipsia (PIP syndrome), seen in the seriously mentally ill, can result in severe biopsychosocial impairment, including an excessive death rate if not identified early. Because of its impact on the health, functioning, and quality of life of the seriously mentally ill patient, all mental health care providers must be aware of the signs and symptoms of PIP syndrome. Physiological, psychological, behavioral, self-care, and social factors all play a role in the manifestation of the syndrome; it follows that a multidisciplinary approach is crucial to ensure early detection, monitoring, and treatment of this problem both in the hospital and in the community. This article explains how we have incorporated the strengths of various disciplinary strategies into a unified treatment model for managing PIP syndrome and its sequelae.

Combined Modality Therapy↗

Polydipsia, hyponatremia, and seizures in psychotic patients.

Case histories are presented for four psychotic patients who ingested large quantities of water and subsequently developed grand mal seizures and serum sodium levels of less than 121 meq/liter. The physiology of psychogenic polydipsia and related disorders is reviewed. The relation of this disorder to temporal lobe seizures and to the use of phenothiazines is considered.

Adult↗

Case report: recurrent pseudocyesis in a male patient with psychosis, intermittent hyponatremia, and polydipsia.

This report describes a case of recurrent pseudocyesis in a man with psychosis, intermittent hyponatremia, and polydipsia. The pseudocyesis was documented on three separate occasions coinciding with bouts of acute hyponatremia and rapid weight gain stemming from ingestion of large amounts of water. In contrast, no pseudocyesis was elicited during intervening normonatremic states. Abdominal distention, neuropsychological deterioration, and worsening of psychosis during acute hyponatremia are considered as contributing factors to the pseudocyesis.

Adult↗

The effects of amphetamine, phencyclidine, dopaminergic antagonists and atypical neuroleptics on schedule-induced polydipsia (SIP) are distinguishable.

The effects of amphetamine, phencyclidine, dopaminergic blockers and atypical neuroleptics on the acquisition of schedule-induced polydipsia in rats were compared in a chronic dose regime followed by 7 days of withdrawal. All compounds suppressed water intake. However, different mechanisms were responsible. The antidopaminergic compounds inhibited the initiation of drinking, as the temporal pattern of licking was shifted to the right. Phencyclidine inhibited the maintenance of drinking as the number of licks/ml water consumed was increased. The suppressing effect of amphetamine may have been due to the reduction of high rates of licking and/or a competition between licking and locomotor or other amphetamine-induced activities. The number of panel entries were increased by amphetamine and phencyclidine. The typical antidopaminergic compounds decreased the number of panel pushes, whereas the atypical antidopaminergic compounds were without effect on this parameter. In conclusion, it was possible to differentiate between the types of compounds investigated by comparing their effects on water intake, panel pressing, drinking efficiency and the temporal patterns of licking and panel pressing.

Journal Article↗

The effect of risperidone on schedule-induced polydipsia.

The effects of risperidone on the acquisition of schedule-induced polydipsia in rats were investigated in a chronic dose regime followed by seven days of withdrawal. Risperidone dose-dependently suppressed water intake and number of panel pushes. Drinking efficiency and free water intake in home cages were unchanged. By comparing the effects of risperidone in the present paper with the effects of different-neuroleptics in the same procedure from an earlier study, it appears that the effect of risperidone is intermediary to that of the 'typical' and 'atypical' neuroleptics. It may be concluded that risperidone acts as an atypical neuroleptic compound; however, increasing the dose only two-fold will cause EPS.

Journal Article↗

Polydipsia as another mechanism of hyponatremia after 'ecstasy' (3,4 methyldioxymethamphetamine) ingestion.

Acute symptomatic hyponatremia after ecstasy (3,4 methyldioxymethamphetamine; MDMA) ingestion is well documented and has been attributed to the syndrome of inappropriate antidiuretic hormone (SIADH). We report the case of an 18-year-old woman who took five tablets of ecstasy in a suicide attempt and drank 1700 ml water at the Emergency Department (ED). The laboratory findings obtained 5 h after ingestion showed a serum sodium concentration of 130 mmol/l, plasma osmolality of 264 mOsm/kg, urinary osmolality of 335 mOsm/kg and natriuresis of 101 mmol/l. The plasma arginine vasopressin level by radioimmunoassay was 33.7 pmol/l 5 h after ingestion. A gas chromatography-mass spectrometry assay confirmed MDMA in blood samples, with serum concentrations of 0.87 mg/l on arrival. This case report strongly suggests that MDMA reduces serum sodium levels through the dual pathways of SIADH and polydipsia. Accordingly, we believe that hyponatremia may be prevented in ED patients after MDMA ingestion by the early restriction of water intake.

Adolescent↗

Control of nephroblastoma: associated hypertension and polydipsia by captopril.

A child with nephroblastoma, severe hypertension, polydipsia, and polyuria is presented. Previous reports of this association describe great difficulty in controlling the hypertension by medical means. Captopril provided prompt and continuing control of this child's hypertension and allowed for optimal preparation prior to surgery.

Captopril↗