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Vasopressin in Chronic Psychiatric Patients with Primary Polydipsia

Published online by Cambridge University Press:  02 January 2018

Nicholas J. Delva*
Department of Psychiatry, Queen's University, 72 Barrie Street, Kingston, Ontario, Canada K7L 3J7
John L. Crammer
Institute of Psychiatry, London, England
J. Stuart Lawson
Departments of Psychiatry and Psychology, Queen's University, Kingston
Stafford L. Lightman
Charing Cross and Westminster Medical School, Westminster Hospital, London, England
Michael Sribney
Departments of Psychiatry and Biochemistry, Queen's University
Barbara J. Weir
Psychopharmacology Unit, Kingston Psychiatric Hospital


Twelve chronic in-patients with primary polydipsia were studied, during free drinking and after fasting, by concurrent measurements of plasma AVP, serum sodium and osmolality, and urine volume, AVP, osmolality, and creatinine. A majority of the patients showed inappropriately high levels of AVP: plasma AVP estimations demonstrated that seven had Type I SIADH and two had Type II SIADH. Urinary AVP estimations confirmed inappropriately raised AVP in seven of the subjects tested, and there was a significant agreement between the plasma and urine diagnoses. Although able to concentrate their urine in response to fluid deprivation, the patients showed a decreased renal sensitivity to AVP. Despite the mitigating effect of decreased renal sensitivity to AVP, the SIADH seen in these patients appears to contribute to the development of water intoxication caused by polydipsia.

Copyright © The Royal College of Psychiatrists 

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