Abstract
Psychogenic polydipsia or self-induced water intoxication is a potentially lethal condition seen in many chronic psychiatric patients. This is a literature review based on therapeutic significance of Naltrexone in improving compulsive water drinking behavior in chronic psychiatrically ill patients with psychogenic polydipsia. Naltrexone is an opioid antagonist approved by FDA for alcohol dependence. Extensive literature search provides a line of evidence that suggests correlation of opioid receptor with compulsive water ingestion in animals. However, there is limited data regarding clinical utility of naltrexone in improving psychogenic polydipsia in human species. This review highlights the necessity for further research and trials to elucidate the role of naltrexone in human psychogenic drinking behavior.
Highlights
BackgroundPsychogenic polydipsia (PP) is a chronic episodic condition in psychiatric patients characterized by compulsive drinking of large amounts of water resulting in dilutional hyponatremia and various neurological signs
Psychogenic polydipsia or self-induced water intoxication is a potentially lethal condition seen in many chronic psychiatric patients
This is a literature review based on therapeutic significance of Naltrexone in improving compulsive water drinking behavior in chronic psychiatrically ill patients with psychogenic polydipsia
Summary
Psychogenic polydipsia (PP) is a chronic episodic condition in psychiatric patients characterized by compulsive drinking of large amounts of water resulting in dilutional hyponatremia and various neurological signs. Psychogenic polydipsia or self-induced water intoxication is a relatively common condition in chronic psychiatric patients, occurring from 5 to 10 years after the onset of psychosis. It presents as a chronic condition in 67% of cases, and episodic in 33% of cases [1]. The stereotypic behaviors in PP patients shared some similarity to behaviors observed in LeschNyan syndrome and mentally challenged patients where they showed diminished symptoms after treatment with an opiate antagonist This led Nishikawa et al to speculate the role of naloxone improving PP in some schizophrenics [19,20]. A successfully treated case of PP has been reported where a 47-year old male patient with PP responded well to a combination therapy of irbesartan 300 mg and naltrexone 50 mg [24]
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