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PubMedDate not supplied

Effects of norepinephrine applied to the lateral hypothalamus on schedule induced polydipsia.

Intrahypothalamic injections of 3 doses of norepinephrine were administered to rats under conditions of 80 percent body weight reduction (prepolydipsia), 80 percent body weight reduction (schedule induced polydipsia), and normal body weight (postpolydipsia). The only significant reduction in water intake occurred with the highest dose of norepinephrine, under the prepolydipsic condition. The fact that norepinephrine failed to block schedule induced polydipsia indicates that this behavior is regulated by a different biochemical system than that of deprivation induced drinking.

Animals↗
PubMed1994

Corticotropin-releasing factor and schedule-induced polydipsia.

Two experiments examined the effects of ICV-administered corticotropin-releasing factor (CRF) and alpha-helical CRF (9-41), a CRF antagonist, on the performance of schedule-induced polydipsia (SIP). Infusions of CRF into the lateral ventricle dose-dependently (0.02, 0.1, and 0.5 micrograms) attenuated both the volume of water consumed and licking on a fixed-time 60-s schedule. This effect of CRF on schedule-induced drinking was accompanied by a reduction in the number of nose pokes made into the food tray, suggesting that CRF may attenuate SIP through an action on appetitive motivation. Neither the temporal distribution of responding nor the locomotor activity induced by the schedule was affected by CRF. In marked contrast to these effects of exogenous CRF on the performance of SIP, infusions of alpha-helical CRF (1, 5, and 25 micrograms) into the lateral ventricle did not affect the performance of schedule-induced polydipsia. The implications of these results for the hypothesis that SIP is a coping response to stress are discussed.

Animals↗
PubMed1994

The impact of inter-pellet interval and polydipsia on hypoalgesia elicited by non-contingent food delivery.

Exposure to non-contingent food delivery has been shown to elicit an increase in nociceptive thresholds in rats. The conditions which elicit analgesia are similar to those that elicit schedule-induced polydipsia. In both instances animals are food-deprived and receive food on an intermittent schedule. Interpellet interval has been found to be an important predictor of schedule-induced polydipsia. Experiment 1 therefore investigated the effect of varying the interval between pellet deliveries on tail flick latencies in rats. The relationship between nociceptive threshold and inter-pellet interval was found to be bitonic in nature given that animals submitted to fixed time schedules of 30 or 60 s, but not 15 or 120 s, exhibited significant increases in tail flick latencies. Experiment 2 examined the effect of providing animals with water during exposure to non-contingent food delivery. Under these conditions animals exhibited polydipsic behaviour, the development of which attenuated the hypoalgesic response to non-contingent food delivery.

Animals↗
PubMed1986

Pharmacologic approaches to psychogenic polydipsia: case reports.

Psychiatric patients presenting with chronic psychogenic polydipsia are often difficult to treat with standard psychiatric interventions. Pharmacologic intervention was attempted in three patients and was successful in one. One patient had a significant and sustained reduction of water intake while on 160 mg of propranolol. One patient did not improve with either propranolol or captopril while a third patient showed no improvement of serum sodium with demeclocycline nor reduction of water intake with propranolol. The potential mechanisms by which these pharmacologic agents might alter thirst in patients with primary polydipsia are discussed.

Adult↗
PubMed1986

Adipsia-polydipsia induced by simultaneous lesion of the medioventral septum and anteroventral third ventricle area in the rat.

The medioventral septal area (MVS) and also the tissue surrounding the periventricular preoptic-hypothalamic region (AV3V) of male rats, were destroyed by mean of electrolytic lesions. Before and after the lesions, daily water and food intakes, diuresis, body weight, urine osmolarity, and sodium and potassium excretion were determined. Rats with simultaneous AV3V-MVS lesions showed a biphasic pattern of drinking behavior characterized by a first period of adipsia followed by another period of polydipsia. During the first period of adipsia and except for the first two days, postlesion rats were able to reduce total urine volume but failed to produce an appropriate concentrated urine. During the polydipsia period, on the contrary, rats increased urine output and decreased urine osmolarity in a parallel fashion. Immediately after the lesion, food intake was decreased but recovered to pre-lesion levels gradually. By contrast, body weight was decreased during the entire period of the experiment. Sodium but not potassium excretion showed a significant increase from the 9th to the 20th day postlesion. The results suggest that the AV3V and MVS are part of a circuitry subserving the control of water intake and electrolyte balance.

Animals↗
PubMed1990

Polydipsia in the chronically mentally ill: a review.

Polydipsia, or excessive intake of water, is reviewed in the chronically mentally ill from a nursing perspective. The purpose of this article is to review research related to excessive water ingestion, the magnitude and types of problems that these patients experience, and the treatment interventions reported. Future research and practice should focus on understanding the patient's experience of polydipsia and how it relates to the patient's level of functioning, testing assessment tools, and determining appropriate interventions.

Chronic Disease↗
PubMed2005

Association of an orexin 1 receptor 408Val variant with polydipsia-hyponatremia in schizophrenic subjects.

BACKGROUND: Primary polydipsia is a common complication in patients with chronic psychoses, particularly schizophrenia. Disease pathogenesis is poorly understood, but one contributory factor is thought to be dopamine dysregulation caused by prolonged treatment with neuroleptics. Both angiotensin-converting enzyme (ACE) and orexin (hypocretin) signaling can modulate drinking behavior through interactions with the dopaminergic system. METHODS: We performed association studies on the insertion/deletion (I/D) sequence polymorphism of ACE and single nucleotide polymorphisms within the prepro-orexin (HCRT), orexin receptor 1 (HCRTR1), and orexin receptor 2 (HCRTR2) genes. Genotypes were determined by polymerase chain reaction amplification, followed by either electrophoretic separation or direct sequencing. RESULTS: The ACE I/D polymorphism showed no association with polydipsic schizophrenia. Screening of the orexin signaling system detected a 408 isoleucine to valine mutation in HCRTR1 that showed significant genotypic association with polydipsic-hyponatremic schizophrenia (p = .012). The accumulation of this mutation was most pronounced in polydipsic versus nonpolydipsic schizophrenia (p = .0002 and p = .008, for the respective genotypic and allelic associations). The calcium mobilization properties and the protein localization of mutant HCRTR1 seem to be unaltered. CONCLUSION: Our preliminary data suggest that mutation carriers might have an increased susceptibility to polydipsia through an undetermined mechanism.

Adult↗
PubMed1997

Hyperuricemia as a clue for central diabetes insipidus (lack of V1 effect) in the differential diagnosis of polydipsia.

PURPOSE: In the differential diagnosis of patients with polyuria-polydipsia one must distinguish usually between primary polydipsia (PP) and central diabetes insipidus (CDI). The first situation is a state of volume expansion and the second of volume contraction. We evaluate whether serum uric acid determination could help to differentiate between the two conditions. PATIENTS AND METHODS: We analyzed the score of 13 consecutive patients with CDI, 7 patients with PP, and 7 patients with nephrogenic diabetes insipidus (NDI). Serum uric acid concentration was available during normonatremia without treatment with 1-desamino-8-D-arginine vasopressin (dDAVP), during mild dehydration and during treatment with dDAVP. In 8 of these patients plasma renin activity (PRA), urate, urea and creatinine clearances were also available. These data were also obtained in the patients with NDI. In 1 patient with CDI, we studied the effect on urate clearance of dDAVP, which stimulates exclusively the V2 receptors, and of triglycyl-lysine-vasopressin (TGLV), a potent V1-receptor agonist. RESULTS: Normonatremic polydypsic patients with CDI presented an increase in uric acid concentration (7.1 +/- 2.2 mg/dL), whereas in the PP group the value was decreased (3 +/- 0.75 mg/dL; P <0.001). All the normonatremic PP presented a serum uric acid concentration lower than 5 mg/dL, whereas all the normonatremic CDI patients, exept 1, presented a value higher than 5 mg/dL. In both groups blood urea concentration was decreased as a consequence of high renal clearances. The hyperuricemia of CDI was related to low uric acid clearances. Patients with hypernatremia and NDI presented a lower increase in serum uric acid concentration than those with similar levels of hypernatremia and CDI (NDI: 5.7 +/- 0.8 mg/dL and CDI: 7.9 +/- 2.3 mg/dL; P <0.05) and the NDI patients presented an urate clearance corrected for creatinine clearance which was significantly higher than in CDI (9% +/- 3% and 4% +/- 1.1%; P <0.01). When the patients with CDI were treated with dDAVP and normalyzed their PRA (0.9 +/- 0.4 ng/mL/h) we observed still mild hyperuricemia compared to controls (5.5 +/- 1.4 mg/dL and 4.3 +/- 0.9 mg/dL; P <0.01) and a low fractional excretion of filtered uric acid (6.5% +/- 1.7% compared to 8.2% +/- 2% in controls; P <0.05). Acute administration of dDAVP, stimulating the V2 receptors, in one patient with CDI, had no effect on urate clerance, while TGLV, which stimulates the V1 receptor, increased urate clearance. CONCLUSION: The presence of an serum uric acid concentration higher than 5 mg/dL in polyuric polydipsic patients is highly suggestive of CDI. Even when these patients are treated with dDAVP many of them remain hyperuricemic, and this seems to be the consequence of a lack of V1 receptor stimulation.

Adult↗
PubMed1997

Delusional pregnancy with polydipsia: a case report.

We report a case of delusional pregnancy with polydipsia in a female patient with paranoid schizophrenia. The contribution of psychological and physiological factors in the development of the delusion of pregnancy and polydipsia and the possible interactions between the two phenomena are discussed.

Adult↗
PubMed1992

Functional obstructive uropathy: a significant factor in the hyponatremia of psychogenic polydipsia?

A case is presented of psychogenic polydipsia with hyponatremia. Prolonged observation of the patient revealed that episodes of hyponatremia correlated best with bladder failure and were promptly corrected by bladder catheterization. Bladder catheterization for underlying functional obstructive uropathy should be considered early in the treatment of patients with psychogenic polydipsia and hyponatremia.

Adult↗
PubMed1999

Schedule-induced polydipsia: gender-specific effects and consequences of prenatal cocaine and postnatal handling.

The impact of gestational cocaine in conjunction with postnatal handling on schedule-induced polydipsia (SIP) was examined. Rat offspring were derived from Sprague-Dawley dams injected subcutaneously with 40 mg/kg/3 cc cocaine hydrochloride (C40) on gestational days 8-20, dams injected with vehicle and pair fed 4 (PF4) days to mimic the acute anorexic effects of cocaine administration, and nontreated (NT) control dams. In adulthood, offspring were food deprived and given 13 daily 30-min SIP sessions, with water intake recorded during the scheduled (fixed time 60 s-FT60) food delivery. For 4 days thereafter, animals received saline, 5 or 10 mg/kg of cocaine in counterbalanced order prior to SIP testing. Acquisition and maintenance of SIP, but not cocaine-induced suppression of SIP performance, were observed to be dependent upon prenatal treatment, handling, and gender. Females acquired SIP faster and exhibited notably higher levels of polydipsia than males. Early handling increased levels of established SIP in NT offspring, while enhancing SIP acquisition in both PF4 and C40 offspring. In nonhandled animals, NT offspring exhibited less SIP than PF4 and C40 offspring, differences that were attenuated by early handling. These effects are discussed in relation to previously reported neurohormonal characteristics of these gender and treatment variables.

Analysis of Variance↗
PubMed1997

Reduction of hyponatremia in a schizophrenic with polydipsia-hyponatremia syndrome by surgical intervention.

In a chronic schizophrenic with polydipsia-hyponatremia syndrome, we observed physiological data consecutively before and after a successful LAPIDES vesicostomy for his bladder retention. Although his polydipsia was unchanged, frequency of hyponatremia was significantly reduced after the operation. We found that bladder retention might be one of the factors relevant to the prediction of hyponatremia from diurnal weight gain.

Adult↗
PubMed1989

Diagnostic approach to polydipsia and polyuria.

A variety of metabolic disturbances account for the majority of cases of polydipsia and polyuria. This chapter presents guides to differential diagnosis as well as a discussion of the etiology and clinical features of the primary causes--central diabetes insipidus, nephrogenic diabetes insipidus, and psychogenic polydipsia.

Animals↗
PubMed1999

Subclinical polydipsia and polyuria in young patients with schizophrenia or obsessive-compulsive disorder vs normal controls.

1. Increased water intake and output is more common among psychiatric patients, especially those with schizophrenia, than in the general population. Animal studies suggest that polydipsia and polyuria derive, in part, from dopamine dysregulation. Stimulated by these observations this study sought to elucidate relationships among water homeostasis, monoamine metabolism, and electrolyte excretion in schizophrenic patients with and without paranoid hallucinatory symptoms (PH vs. NP), thought to reflect hyper- and hypo-dopaminergic states respectively, and to compare these with those shown by patients with obsessive compulsive disorder (OCD). 2. 24 hr-urine samples for electrolyte, monoamine and metabolite measures were taken from 14 schizophrenic patients with PH symptoms, 13 with predominantly nonparanoid (NP) symptoms, 11 OCD patients and 27 healthy controls (matched for age, weight and creatinine production). Water intake and serum electrolytes was sampled during psychological testing. 3. PH patients drank 2-3 times more than the others in a 3-4 hr test, yet 24 hr-urinary volumes were 75% larger in both PH and NP patients than in the two comparison groups. 4. Daily potassium excretion was a bit higher in PH patients, but concentrations of sodium, potassium and phosphate tended to be lower in PH and NP patients than in the others. 5. Positive associations of electrolyte with homovanillic acid excretion were consistent across groups and not directly related to medication. But associations of electrolyte excretion with noradrenergic activity in controls were absent in psychotic patients and associations with serotonin in OCD patients were absent in the other groups. 6. Increased water intake and output in PH patients along with the disturbed association with noradrenergic metabolism are consistent with altered autonomic activity in these patients. 7. The independence of measures of water homeostasis from dopaminergic medication indicates that the associations in clinically responding PH patients of polydipsia with DA function (decreased DA levels) may be pertinent to this subgroup but not to schizophrenia in general.

Adolescent↗
PubMed2001

Sodium cloprostenol administered at a continuous low dosage induces polydipsia and suppresses luteal function in early dioestrous bitches.

The aim of this study was to determine whether sodium cloprostenol administered at a continuous low dosage induced luteolysis and polydipsia in early dioestrous bitches. Sodium cloprostenol was administered subcutaneously to greyhounds at doses of 4.04-5.19 microg/kg/day (treated group, n=5) or 0 microg/kg/day (control group, n=5) delivered by mini-osmotic pumps for 7 days. The treated bitches and two of the control bitches were in early dioestrus (Days 5-14, and 6 and 10, respectively) when the mini-osmotic pump was inserted (Day 0). Concentrations of plasmatic progesterone were measured in dioestrous bitches each day from Day -2 to 7, and then weekly until Day 90. Daily intake of water was ascertained in all bitches from Day -2 until Day 10, and their weight was measured on Days -2, 6 and 13. Biochemical analyses on plasma for concentrations of urea and glucose, and urinalyses were performed on all bitches before (Day -1), during (Day 4) and after treatment (Day 10). Concentrations of plasmatic progesterone declined dramatically and rapidly in treated bitches after Day 0 to <2.9 ng/ml but were not similarly affected in the dioestrous control bitches. However, in three of five treated bitches, concentrations of plasmatic progesterone increased to >1 ng/ml in the period from Day 10 to 90 indicating that luteolysis was incomplete. All treated bitches were polydipsic (intake of water >100 ml/kg/day) for 2-6 days during the period of treatment, and for 0-2 days immediately after treatment (Days 7 and 8). One control bitch was polydipsic on Days -2, -1 and 0. The treated bitches were also polyuric since they were hyposthenuric (<1.007, n=4) or isothenuric (1.010, n=1) on Day 4, their weight did not increase and no gastrointestinal or respiratory effects were observed. The control bitches were always hypersthenuric when measured during and after treatment (>1.021). Biochemical analyses of plasma and other data obtained from urinalyses did not reveal any differences between groups. This study indicated that sodium cloprostenol administered at a continuous low dosage induced polydipsia and suppressed luteal function in early dioestrous bitches.

Animals↗
PubMed2000

Polydipsia and water intoxication in 353 psychiatric inpatients: an epidemiological and psychopathological study.

INTRODUCTION: According to several authors, water intoxication can lead to irreversible brain damage and could be the cause of nearly a fifth of the deaths of schizophrenic patients below the age of 53 years. The aim of our study was first to determine the prevalence of polydipsia and water intoxication in a population of psychiatric inpatients of a well-defined French geographic area (the Somme), and secondly to determine the clinical and socio-demographic factors associated with this disorder. METHOD: A cross-sectional survey was done on the 450 psychiatric beds whose catchment area had a total population of 559,429 inhabitants. Using staff reports and patients' charts, the drinking habits of 353 psychiatric inpatients hospitalised during the survey in the 450 psychiatric beds of this area were examined. RESULTS: Thirty-eight patients (10.76%; 95% confidence interval: 7.53-13.99%) among the 353 inpatients were polydipsic. About one-third of these patients were at risk of water intoxication. Polydipsia appeared to be significantly associated with male gender, smoking, celibacy and chronicity. The polydipsic patients presented also a high prevalence of schizophrenia, mental retardation, pervasive developmental disorders and high frequency of somatic disorders.

Adolescent↗
PubMed2006

Salt wasting, hypotension, polydipsia, and hyponatremia and the level of spinal cord injury.

STUDY DESIGN: Case control. OBJECTIVE: To test the reported correlation of hypotension, polydipsia, and hyponatremia with higher levels of spinal cord injury (SCI). SETTING: A Veterans Administration Hospital, USA. METHODS: The records of men who were paralyzed owing to trauma at any spinal cord level with motor complete lesions (ASIA A or B) and who received an annual physical and laboratory examination were reviewed for age, duration of paralysis, level of paralysis, blood pressure (BP), serum sodium, and 24 h urinary volume, creatinine, and sodium. Creatinine clearance and fractional excretion of sodium (FcNa) were calculated. Spearman rank-order correlations (r (s)) were carried out. RESULTS: Patients were aged 25 to 88 years, median 56 years, paralyzed 2-61 years, median 26 years, with levels of paralysis ranging from C2 to L4, median T4, n=111. From lower to higher levels of paralysis FcNa increased (0.4-7.3%), mean BP diminished (132-66 mmHg), urine volume increased (600-5400 ml), and serum sodium was reduced (148-129 mEq/l) - r (s)=0.29, 0.49, -0.22, and 0.23, respectively. Increasing 24 h urinary volumes correlated with lower serum sodium concentrations but higher creatinine clearance, r (s)=-0.28, 0.24. Increasing 24 h urinary sodium improved creatinine clearance, r (s)=0.37. P-values ranged from <0.05 to <0.001. CONCLUSION: Higher levels of SCI correlate with reduced sodium conservation, hypotension, polydipsia, and hyponatremia. Greater water intake raises creatinine clearance but lowers serum sodium. Greater salt intake increases creatinine clearance.

Adult↗
PubMed2001

Treatment of psychogenic polydipsia: comparison of risperidone and olanzapine, and the effects of an adjunctive angiotensin-II receptor blocking drug (irbesartan).

OBJECTIVE: Our objective was to determine the outcome of novel strategies in managing a case of severe polydipsia. CLINICAL PICTURE: The patient was a 39-year-old male with a 20-year history of paranoid schizophrenia who, despite only mild residual psychotic symptoms, had been hospitalized for the previous 10 years because of severe polydipsic behaviour complicated by water intoxication. TREATMENT: Novel antipsychotic agents, risperidone and olanzapine, as well as the specific angiotensin-II receptor blocking drug, irbesartan were employed at selected intervals in a study lasting nearly 3 years. A strict behavioural management programme was ongoing, in which diurnal weight change and the number of breaches of weight limits, requiring management in a low-stimulus environment, were documented on a daily basis. Summary measures of diurnal weight change and behavioural intervention were charted against changes in treatment. OUTCOME: Polydipsic behaviour improved on risperidone up to 4 mg daily, but was not sustained. Olanzapine was similarly successful in stabilizing polydipsia, and improvement was achieved with the addition of irbesartan. CONCLUSION: We suggest that the D2-sparing profiles of receptor binding achieved with low-dose risperidone and olanzapine may account for this beneficial effect. The benefit derived with irbesartan implicates the involvement of brain angiotensin systems centrally in helping to regulate drinking behaviour.

Adult↗