Hostname: page-component-77c89778f8-7drxs Total loading time: 0 Render date: 2024-07-22T10:11:59.575Z Has data issue: false hasContentIssue false
  • English
  • Français

Neuroleptic induced polydipsia and hyperphagia in an adult with learning disability

Published online by Cambridge University Press:  13 June 2014

Candida Graham  and
Syed Hasan Jawed
Syed Hasan Jawed
Affiliation:
Cherry Orchard House, 35 Hospital Street, Tamworth, Staffordshire B79 7EE, England
Get access Rights & Permissions [Opens in a new window]

Abstract

This case report is of a young male with learning disability, who presented with long-term polydipsia and hyperphagia. The patient's polydipsia and hyperphagia showed a correlation with long-term use of neuroleptics for behavioural problems. Withdrawal of all neuroleptic medication resulted in an immediate improvement in both the polydipsia and hyperphagia leading to a complete resolution of both symptoms. While neuroleptics are a recognised cause of polydipsia, hyperphagia is less frequently described and we believe this to be the first report in which a patient is observed to have polydipsia and hyperphagia induced by neuroleptics. We discuss the possible aetiological mechanisms for both polydipsia and hyperphagia and conclude that the basic pathophysiology in our case appears to be a neuroleptic induced malfunction of the satiety centre due to blockage of dopamine receptors in the ventromedial hypothalamus.

Keywords

PolydipsiaHyperphagiaNeurolepticsAntipsychotics
Type
Case Report
Information
Irish Journal of Psychological Medicine , Volume 15 , Issue 2 , June 1998 , pp. 70 - 72
Copyright
Copyright © Cambridge University Press 1998

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Illowsky, BP, Kirch, DC. Polydipsia and hyponatraemia in psychiatric patients. Am J of Psychiatry 198; 143: 673–83.Google Scholar
2.Rowntree, LU. Water intoxication. Arch Int Medicine 1923; 32: 137–74.Google Scholar
3.Delva, NJ, Crammer, JL, Javzylo, SVet al.Osteopenia, pathological fractures and increased urinary calcium excretion in schizophrenic patients with polydipsia. Biol Psychiatry 1989; 26: 781–91.Google Scholar
4.Vieweg, WVR, David, SS, Rowe, WTet al.Psychogenic polydipsia and water intoxication. Biological Psychiatry 1987; 20: 1308–20.Google Scholar
5.Blum, A, Tempey, FW, Lynch, WS. Somatic findings in patients with psychogenic polydipsia. J Clin Psychiatry 1983; 44: 33–56.Google Scholar
6.Jos, CJ, Perez-Cruet, S. Incidence and morbidity of self-induced water intoxication in state mental hospital patients. Am S Psychiatry 1979; 136: 221–2.Google Scholar
7.Jos, CJ, Evenson, RC, Mallya, KR. Self-induced water intoxication: A comparison of 34 cases with matched controls. J Clin Psychiatry 1986; 47: 368–70.Google Scholar
8.Barlow, ED, Dewardener, HE. Compulsive water drinking. Q J Med 1959; 110: 235–58.Google Scholar
9.Bremner, AS, Regan, A. Intoxicated by water. Br J Psychiatry 1991; 158: 244–50.Google Scholar
10.Deb, S, Bramble, D, Drybala, Get al.Polydipsia amongst adults with learning disability in an institution. Journal of Intellectual Disability Research 1994; 38: 359–67.Google Scholar
11.Glusac, MD, Patel, H, Josef, NCet al.Polydipsia and hyponatraemia induced by multiple neuroleptics but not molidine. Can J Psychiatry 1990; 35: 268–9.Google Scholar
12.Nishikawa, T, Tsuda, A, Tanaka, Met al.Evidence for a direct adverse reaction of neuroleptics in self-induced water intoxication of psychiatric patients. Kurume Med J 1991: 38(4): 307–10.Google Scholar
13.Rao, KJ, Miller, M, Mosses, A. Water intoxication and thioridazine. Ann Internal Med 1975; 82: 61–3.Google Scholar
14.Shen, WW. and Sata, LS. Hypothalamic dopamine receptor supersensitivity? A pilot study of self induced water intoxication. Psychiatr J University of Ottawa 1983; 8: 154–8.Google Scholar
15.Hobson, SA, English, JT. Self-induced water intoxication. Ann Int Med 1963; 58: 324–32.Google Scholar
16.Umbricht, DS, Saltz, B, Pollack, Set al.Polydipsia and tardive dyskinesia in chronic psychiatric patients – related disorders? Am J Psychiatry 1994; 151, 1716–7.Google Scholar
17.Sandifer, MG. Hyponatremia due to psychotropic drugs. J Cl Psychiatry 1983; 44: 301–33.Google Scholar
18.Erickson, RK, Brown, FD, Schaible, KL, et al.The effect of foetal hypothalamus grafts on weight gain resulting from lesions of the ventro-medial hypothalamus. J Neurosurgery 1988; 68: 112–6.CrossRefGoogle Scholar
19.Beverly, JL, Martin, RS. Increased GABA stunt activity in VMN of three hyperphagic rat models. Am J Physiology 1989; 256: R1225–R1231.Google Scholar
20.Hope, RA, Allaman, P. Hyperphagia in dementia. Fluvoxamine takes the biscuit. J Neurology, Neurosurgery and Psychiatry 1991; 54(1): 88.Google Scholar
21.Hutson, PH, Dourish, CT, Curzon, G. Neurochemical and behavioural evidence for mediation of the hyperphagic action of 8-OH-DPAT by 5-HT cell body autoreceptors. Eur J Pharmacology 1986; 129: 347–52.Google Scholar
22.Skuse, D, Albanese, A, Stanhope, Ret al.A new stress-related syndrome of growth failure and hyperphagia in children, associated with reversibility of growth-hormone insufficiency. Lancet 1996; 348: 1104–5.Google Scholar
23.Chesson, AL, Levine, SN, Kong, LSet al.Neuroendocrine evaluation in Kleine-Levin syndrome: evidence of reduced dopaminergic tone during periods of hypersomnolence. Sleep 1991; 14: 226–32.Google Scholar
24.Hernandez, L, Parada, M, Hoebel, BG. Amphetamine-induced hyperphagia and obesity caused by intraventricular or lateral hypothalamic injections in rats. J Pharmacology and Experimental Therapeutics 1983; 227: 524–30.Google Scholar
25.Molloy, AG, Waddincton, JL. Behavioural responses to the selective D–dopamine receptor against R-Sk&F 38393 and the selective D2-against RV 24213 in young compared with aged rats. Br J Pharmacology 1988; 95: 335–42.Google Scholar
26.Sugimoto, Y, Yamada, S, Yoshikawa, Tet al.Effects of peripheral 5-HT2 and 5-HT3 receptor agonists on food intake in food-deprived and 2-deoxy-D glucose-treated rats. Eur J Pharmacology 1996; 316, 15–21.Google Scholar
27.Carruba, MO, Mantegazza, P, Memo, Met al.Peripheral and central mechanisms of action of serotoninergic anoretic drugs. Appetite 1986; Suppl 7: 105–13.Google Scholar