Drug Safety

, Volume 33, Issue 2, pp 101–114 | Cite as

Antipsychotic-Induced Hyponatraemia

A Systematic Review of the Published Evidence
  • Didier Meulendijks
  • Cyndie K. Mannesse
  • Paul A. F. Jansen
  • Rob J. van Marum
  • Toine C. G. Egberts
Review Article


Hyponatraemia is known to occur as a rare but clinically important adverse reaction to treatment with different psychotropic drugs, including selective serotonin reuptake inhibitors and antiepileptic drugs. In past decades, reports have been published that describe the development of hyponatraemia in association with antipsychotic drug treatment. Our objective was to systematically review the available evidence on antipsychotic-induced hyponatraemia, focussing on patient characteristics, drug dosage, polydipsia and the syndrome of inappropriate secretion of antidiuretic hormone (SIADH).

A search was carried out in the MEDLINE and EMBASE databases from January 1966 to 11 April 2009. Inclusion criteria were (i) hyponatraemia (serum sodium level <136 mmol/L) occurring after the start of treatment with an antipsychotic drug; and (ii) that the hyponatraemia potentially occurred as an adverse reaction to antipsychotic drug treatment in accordance with the WHO definition. Articles in languages other than English, Dutch, German, French and Spanish were excluded. Information on patient characteristics, medical and diagnostic data, pharmacological treatment, drug dechallenge and drug rechallenge were extracted from the publications whenever available. A causality assessment was performed on all case reports using Naranjo’s adverse drug reaction probability scale. Correlational analysis was performed to assess correlations between antipsychotic drug dosage and both serum sodium level and time to onset of hyponatraemia.

We included four studies and 91 publications containing case reports and case series; no randomized controlled studies were identified. Data from the identified case reports were further analysed. The mean age of the patients was 46 years; 57% were male. The diagnosis was schizophrenia in 70% of the cases. A history of polydipsia was diagnosed as positive in 67% of the cases and negative in 23% of the cases. Polydipsia occurred in the remaining 10% of cases, although it was reported to be drug-induced (i.e. a severe increase in water intake was observed in relation to treatment with the suspected drug). Analysis of the case reports using the adverse drug reaction probability scale indicated possible causality in most cases (80%), probable causality in a significant amount of cases (19%) and unlikely causality in one case (1%). Overall correlational analysis yielded no significant correlations between defined daily dose-equivalent dosages and serum sodium or time to onset of hyponatraemia.

The incidence of hyponatraemia induced by antipsychotics may be much higher than is currently thought. Both the newer atypical antipsychotics and the older drugs have been associated with the development of hyponatraemia. Physicians, psychiatrists and other healthcare workers should be aware of the possibility of hyponatraemia associated with the use of antipsychotics. Further studies are required to establish the risks of and risk factors associated with antipsychotic-induced hyponatraemia.


Clozapine Antipsychotic Drug Atypical Antipsychotic Antipsychotic Treatment Serum Sodium Level 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



This review represents original material that has not been presented previously. No financial support was used for this review; the investigators conducted the review as part of their regular work schedule. The authors have no financial or other relationships relevant to the subject of this review and have no conflicts of interest to declare. We thank the documentary centre of the Parnassia Bavo Group (the Hague, the Netherlands) for their assistance in the retrieval of full-text publications.

Supplementary material

40264_2012_33020101_MOESM1_ESM.pdf (126 kb)
Supplementary material, approximately 129 KB.


  1. 1.
    de Leon J. Polydipsia: a study in a long-term psychiatric unit. Eur Arch Psychiatry Clin Neurosci 2003 Feb; 253(1): 37–9PubMedCrossRefGoogle Scholar
  2. 2.
    Wetterling T. Hyponatremia: an underrated complication in psychiatric patients [in German]. Nervenarzt 1987 Oct; 58(10): 625–31PubMedGoogle Scholar
  3. 3.
    Riggs AT, Dysken MW, Kim SW, et al. A review of disorders of water homeostasis in psychiatric patients. Psychosomatics 1991 Spring; 32(2): 133–48PubMedCrossRefGoogle Scholar
  4. 4.
    Adrogue HJ, Madias NE. Hyponatremia. N Engl J Med 2000 May 25; 342(21): 1581–9PubMedCrossRefGoogle Scholar
  5. 5.
    Palmer BF, Gates JR, Lader M. Causes and management of hyponatremia. Ann Pharmacother 2003 Nov; 37(11): 1694–702PubMedCrossRefGoogle Scholar
  6. 6.
    Kumar S, Rubin S, Mather PJ, et al. Hyponatremia and vasopressin antagonism in congestive heart failure. Clin Cardiol 2007 Nov; 30(11): 546–51PubMedCrossRefGoogle Scholar
  7. 7.
    Madhusoodanan S, Bogunovic OJ, Moise D, et al. Hyponatraemia associated with psychotropic medications: a review of the literature and spontaneous reports. Adverse Drug React Toxicol Rev 2002; 21(1–2): 17–29PubMedGoogle Scholar
  8. 8.
    Wicki J, Rutschmann OT, Burri H, et al. Rhabdomyolysis after correction of hyponatremia due to psychogenic polydipsia possibly complicated by clozapine. Ann Pharmacother 1998 Sep; 32(9): 892–5PubMedCrossRefGoogle Scholar
  9. 9.
    Zaidi AN. Rhabdomyolysis after correction of hyponatremia in psychogenic polydipsia possibly complicated by ziprasidone. Ann Pharmacother 2005 Oct; 39(10): 1726–31PubMedCrossRefGoogle Scholar
  10. 10.
    Movig KL, Leufkens HG, Lenderink AW, et al. Association between antidepressant drug use and hyponatraemia: a case-control study. Br J Clin Pharmacol 2002 Apr; 53(4): 363–9PubMedCrossRefGoogle Scholar
  11. 11.
    Ajlouni K, Kern MW, Tures JF, et al. Thiothixene-induced hyponatremia. Arch Intern Med 1974 Dec; 134(6): 1103–5PubMedCrossRefGoogle Scholar
  12. 12.
    Peck V, Shenkman L. Haloperidol-induced syndrome of inappropriate secretion of antidiuretic hormone. Clin Pharmacol Ther 1979 Oct; 26(4): 442–4PubMedGoogle Scholar
  13. 13.
    Kimelman N, Albert SG. Phenothiazine-induced hyponatremia in the elderly. Gerontology 1984; 30(2): 132–6PubMedCrossRefGoogle Scholar
  14. 14.
    Rider JM, Mauger TF, Jameson P, et al. Water handling in patients receiving haloperidol decanoate. Ann Pharmacother 1995 Jul–Aug; 29(7–8): 663–6PubMedGoogle Scholar
  15. 15.
    Bachu K, Godkar D, Gasparyan A, et al. Aripiprazole-induced syndrome of inappropriate antidiuretic hormone secretion (SIADH). Am J Ther 2006 Jul–Aug; 13(4): 370–2PubMedCrossRefGoogle Scholar
  16. 16.
    Whitten JR, Ruehter VL. Risperidone and hyponatremia: a case report. Ann Clin Psychiatry 1997 Sep; 9(3): 181–3PubMedGoogle Scholar
  17. 17.
    Edwards IR, Aronson JK. Adverse drug reactions: definitions, diagnosis, and management. Lancet 2000 Oct 7; 356(9237): 1255–9PubMedCrossRefGoogle Scholar
  18. 18.
    Kelly WN, Arellano FM, Barnes J, et al. Guidelines for submitting adverse event reports for publication. Drug Saf 2007;30(5): 367–73PubMedCrossRefGoogle Scholar
  19. 19.
    Bartter FC, Schwartz WB. The syndrome of inappropriate secretion of antidiuretic hormone. Am J Med 1967 May; 42(5): 790–806PubMedCrossRefGoogle Scholar
  20. 20.
    Ellison DH, Berl T. Clinical practice: the syndrome of inappropriate antidiuresis. N Engl J Med 2007 May 17; 356(20): 2064–72PubMedCrossRefGoogle Scholar
  21. 21.
    Rijcken CA, Monster TB, Brouwers JR, et al. Chlorpro-mazine equivalents versus defined daily doses: how to compare antipsychotic drug doses? J Clin Psycho-pharmacol 2003 Dec; 23(6): 657–9CrossRefGoogle Scholar
  22. 22.
    Naranjo CA, Busto U, Sellers EM, et al. A method for estimating the probability of adverse drug reactions. Clin Pharmacol Ther 1981 Aug; 30(2): 239–45PubMedCrossRefGoogle Scholar
  23. 23.
    Brown K, Levy H, Brenner C, et al. Overdose of risperidone. Ann Emerg Med 1993 Dec; 22(12): 1908–10PubMedCrossRefGoogle Scholar
  24. 24.
    Epelde Gonzalo F. Malignant neuroleptic syndrome and hyponatremia associated with risperidone poisoning [letter]. An Med Interna 2002 Jan; 19(1): 50PubMedGoogle Scholar
  25. 25.
    Bonuzzi L, Cesario V, Concari G, et al. Polydipsia and acute water intoxication in chronic schizophrenic patients: report of 4 cases. Minerva Psichiatr 1998; 39(1): 53–6 111Google Scholar
  26. 26.
    Cordopatri F, Fraticelli C, Tafani O. Episodic hypona-tremia in psychiatric patients treated with neuroleptic agents. Rass Studi Psichiatr 1990; 79(1): 33–8Google Scholar
  27. 27.
    Zaffiri O, Centi R, Bisiani M, et al. A favorably resolved case of acute mixed poisoning with luminal (30 g) and neuroleptics (15 g). Minerva Anestesiol 1970; 36(11): 720–4PubMedGoogle Scholar
  28. 28.
    Zaluska M, Janota B, Papierska L, et al. Three cases of hyponatraemia among patients with mental disorders. Postepy Psychiatrii i Neurologii 2007; 16 Suppl. 1: 27–32Google Scholar
  29. 29.
    Koide H. Three cases of hyponatremia during administration of pimozide [in Japanese]. No To Hattatsu 1991 Sep; 23(5): 502–5PubMedGoogle Scholar
  30. 30.
    Yamaguchi K, Takamoto K, Yagi K, et al. Neuroleptic malignant syndrome associated with the syndrome of inappropriate secretion of antidiuretic hormone. Clin Neurol 1995; 35(2): 180–3Google Scholar
  31. 31.
    Kar N, Sharma PS, Tolar P, et al. Polydipsia and risperidone. Aust N Z J Psychiatry 2002 Apr; 36(2): 268–70PubMedGoogle Scholar
  32. 32.
    de Leon J, Verghese C, Stanilla JK, et al. Treatment of polydipsia and hyponatremia in psychiatric patients: can clozapine be a new option? Neuropsychopharmacology 1995 Apr; 12(2): 133–8PubMedCrossRefGoogle Scholar
  33. 33.
    Henderson DC, Goff DC. Clozapine for polydipsia and hyponatremia in chronic schizophrenics. Biol Psychiatry 1994 Dec 1; 36(11): 768–70PubMedCrossRefGoogle Scholar
  34. 34.
    Lyster C, Miller AL, Seidel D, et al. Polydipsia and clozapine. Hosp Community Psychiatry 1994 Jun; 45(6): 610–1PubMedGoogle Scholar
  35. 35.
    Fuller MA, Jurjus G, Kwon K, et al. Clozapine reduces water-drinking behavior in schizophrenic patients with polydipsia. J Clin Psychopharmacol 1996 Aug; 16(4): 329–32PubMedCrossRefGoogle Scholar
  36. 36.
    Canuso CM, Goldman MB. Clozapine restores water balance in schizophrenic patients with polydipsia-hypona-tremia syndrome. J Neuropsychiatry Clin Neurosci 1999 Winter; 11(1): 86–90PubMedGoogle Scholar
  37. 37.
    Canuso CM, Goldman MB. Does minimizing neuroleptic dosage influence hyponatremia? Psychiatry Res 1996 Jul 31; 63(2–3): 227–9PubMedCrossRefGoogle Scholar
  38. 38.
    Jos CJ, Evenson RC, Mallya AR. Self-induced water intoxication: a comparison of 34 cases with matched controls. J Clin Psychiatry 1986 Jul; 47(7): 368–70PubMedGoogle Scholar
  39. 39.
    Spigset O, Hedenmalm K. Hyponatremia during treatment with clomipramine, perphenazine, or clozapine: study of therapeutic drug monitoring samples. J Clin Psychopharmacol 1996 Oct; 16(5): 412–4PubMedCrossRefGoogle Scholar
  40. 40.
    Korzets A, Ori Y, Floro S, et al. Case report: severe hyponatremia after water intoxication: a potential cause of rhabdomyolysis. Am J Med Sci 1996 Aug; 312(2): 92–4PubMedCrossRefGoogle Scholar
  41. 41.
    Purcell P, Valmana A. Toxic epidermal necrolysis following chlorpromazine ingestion complicated by SIADH. Postgrad Med J 1996 Mar; 72(845): 186PubMedCrossRefGoogle Scholar
  42. 42.
    Littrell KH, Johnson CG, Littrell SH, et al. Effects of olanzapine on polydipsia and intermittent hyponatremia. J Clin Psychiatry 1997 Dec; 58(12): 549PubMedCrossRefGoogle Scholar
  43. 43.
    Sillifant K, Muir JL, Crabb M, et al. Monitoring of patients on high dose antipsychotic medication. Psychiatr Bull 1997; 21(10): 612–4CrossRefGoogle Scholar
  44. 44.
    Zenone T, Payen C, Durand DV. Hyponatremia and the syndrome of inappropriate antidiuretic hormone secretion induced by risperidone. Eur J Intern Med 1997; 8(2): 131–2Google Scholar
  45. 45.
    Elizalde-Sciavolino C, Racco A, Proscia-Lieto T, et al. Severe hyponatremia, neuroleptic malignant syndrome, rhabdomyolysis and acute renal failure: a case report. Mt Sinai J Med 1998 Sep; 65(4): 284–8PubMedGoogle Scholar
  46. 46.
    Madhusoodanan S, Brenner R, Buff D. Mazapertine and hyponatremia. Biol Psychiatry 1998 Mar 15; 43(6): 466–7PubMedCrossRefGoogle Scholar
  47. 47.
    Verghese C, Abraham G, Nair C, et al. Absence of changes in antidiuretic hormone, angiotensin II, and atrial na-triuretic peptide with clozapine treatment of polydipsia-hyponatremia: 2 case reports. J Clin Psychiatry 1998 Aug; 59(8): 415–9PubMedCrossRefGoogle Scholar
  48. 48.
    Ahlawat SK. Severe hyponatremia in a chronic schizophrenic patient. J Assoc Physicians India 1999 Jul; 47(7): 724–6PubMedGoogle Scholar
  49. 49.
    Ermens AAM, ter Mors AJW, Vlasveld LT. Over een vrouw die niet dorst te stoppen…. Tijdschr Psychiatr 1999; 41(2): 115–9Google Scholar
  50. 50.
    Fanello S, Hubert N, Laine-Cessac B, et al. Drug-induced hyponatremia: three cases in elderly patients. Sem Hop 1999; 75(1–2): 40–4Google Scholar
  51. 51.
    Munzer T, Grundler BM, Miller M. Recurrent hyponatremia, neurologic symptomatology and longstanding intake of levomepromazine [in German]. Schweiz Rundsch Med Prax 1999 Feb 4; 88(6): 237–41Google Scholar
  52. 52.
    Collins A, Anderson J. SIADH induced by two atypical antipsychotics. Int J Geriatr Psychiatry 2000; 15(3): 282–3PubMedCrossRefGoogle Scholar
  53. 53.
    Fernandez Dorado MT, Alcala-Zamora J, Zabaleta Camino JP, et al. Rhabdomyolysis secondary to hyponatremia in psychogenic polydipsia [letter]. Med Clin (Barc) 2001 Oct 27; 117(13): 519Google Scholar
  54. 54.
    Kruse D, Pantelis C, Rudd R, et al. Treatment of psychogenic polydipsia: comparison of risperidone and olanzapine, and the effects of an adjunctive angiotensin-II receptor blocking drug (irbesartan). Aust N Z J Psychiatry 2001; 35(1): 65–8PubMedCrossRefGoogle Scholar
  55. 55.
    Matsumura M, Yamaguchi M, Sato T. Severe hyponatremia in a patient treated with levomepromazine and carbamazepine [letter]. Intern Med 2001 May; 40(5): 459PubMedCrossRefGoogle Scholar
  56. 56.
    Ting JYS. Rhabdomyolysis and polydipsic hyponatraemia [letter]. Emerg Med J 2001; 18(6): 520PubMedCrossRefGoogle Scholar
  57. 57.
    Tolan P, O’Loughlin D, Botha J. Can seizures and rhabdomyolysis be a potentially serious complication of hyponatremia due to polydipsia [letter]? Aust N Z J Psychiatry 2001; 35(3): 386PubMedGoogle Scholar
  58. 58.
    Murty RG, Mistry SG, Chacko RC. Neuroleptic malignant syndrome with ziprasidone. J Clin Psychopharmacol 2002; 22(6): 624–6PubMedCrossRefGoogle Scholar
  59. 59.
    Montgomery JH, Tekell JL. Adjunctive quetiapine treatment of the polydipsia, intermittent hyponatremia, and psychosis syndrome: a case report. J Clin Psychiatry 2003 Mar; 64(3): 339–41PubMedCrossRefGoogle Scholar
  60. 60.
    Schiphorst JPT, Fouwels AJ. Clozapine against thirst: a case study. Tijdschr Psychiatr 2003; 45(10): 641–5Google Scholar
  61. 61.
    Zink M, Sartorius A, Lederbogen F. Remission of polydipsia as antipsychotic effect of clozapine. Eur Psychiatry 2004; 19(5): 320–1 112PubMedCrossRefGoogle Scholar
  62. 62.
    Hsu YJ, Chiu JS, Lu KC, et al. Biochemical and etiological characteristics of acute hyponatremia in the emergency department. J Emerg Med 2005 Nov; 29(4): 369–74PubMedCrossRefGoogle Scholar
  63. 63.
    Sarma S, Ward W, O’Brien J, et al. Severe hyponatraemia associated with desmopressin nasal spray to treat clozapine-induced nocturnal enuresis [letter]. Aust N Z J Psychiatry 2005 Oct; 39(10): 949PubMedCrossRefGoogle Scholar
  64. 64.
    Taskapan C, Sahin I, Taskapan H, et al. Possible malignant neuroleptic syndrome that associated with hypothyroidism. Prog Neuropsychopharmacol Biol Psychiatry 2005 Jun; 29(5): 745–8PubMedCrossRefGoogle Scholar
  65. 65.
    Vandebosch S, Sermijn E, Lacor P. A 48-year-old man with hyponatremia and a large abdominal mass. Tijdschr Geneeskd 2005; 61(3): 192–3CrossRefGoogle Scholar
  66. 66.
    Akkaya C, Sarandol A, Sivrioglu EY, et al. A patient using ziprasidone with polydipsia, seizure, hyponatremia and rhabdomyolysis. Prog Neuropsychopharmacol Biol Psychiatry 2006 Dec 30; 30(8): 1535–8PubMedCrossRefGoogle Scholar
  67. 67.
    van den Heuvel OA, Bet PM, van Dam EW, et al. The syndrome of inappropriate antidiuretic hormone secretion (SIADH) during treatment with the antipsychotic agents haloperidol and quetiapine. Ned Tijdschr Geneeskd 2006 Sep 2; 150(35): 1944–8PubMedGoogle Scholar
  68. 68.
    Margetić B, Aukst-Margetić B, Zarković-Palijan T. Successful treatment of polydipsia, water intoxication, and delusional jealousy in an alcohol dependent patient with clozapine. Prog Neuropsychopharmacol Biol Psychiatry 2006 Sep 30; 30(7): 1347–9PubMedCrossRefGoogle Scholar
  69. 69.
    Tenyi T, Voros V. Successful switch to olanzapine after rhabdomyolysis caused by water intoxication and clozapine use: a case report. Pharmacopsychiatry 2006; 39(4): 157–8PubMedCrossRefGoogle Scholar
  70. 70.
    Atalay A, Turhan N, Aki OE. A challenging case of syndrome of inappropriate secretion of antidiuretic hormone in an elderly patient secondary to quetiapine. South Med J 2007 Aug; 100(8): 832–3PubMedCrossRefGoogle Scholar
  71. 71.
    Behere RV, Venkatasubramanian G, Naveen MN, et al. Aripiprazole-induced hyponatremia: a case report. J Clin Psychiatry 2007; 68(4): 640–1PubMedCrossRefGoogle Scholar
  72. 72.
    Strachan P, Prisco D, Multz AS. Recurrent rhabdomyolysis associated with polydipsia-induced hyponatremia: a case report and review of the literature. Gen Hosp Psychiatry 2007; 29(2): 172–4PubMedCrossRefGoogle Scholar
  73. 73.
    Vucicevic Z, Degoricija V, Alfirevic Z, et al. Fatal hyponatremia and other metabolic disturbances associated with psychotropic drug polypharmacy. Int J Clin Pharmacol Ther 2007; 45(5): 289–93PubMedGoogle Scholar
  74. 74.
    Shaw A, Matthews EE. Postoperative neuroleptic malignant syndrome. Anaesthesia 1995 Mar; 50(3): 246–7PubMedCrossRefGoogle Scholar
  75. 75.
    Rizzieri DA. Rhabdomyolysis after correction of hyponatremia due to psychogenic polydipsia. Mayo Clin Proc 1995 May; 70(5): 473–6PubMedCrossRefGoogle Scholar
  76. 76.
    Looi JCL, Cubis JC, Saboisky J. Hyponatremia, convulsions and neuroleptic malignant syndrome in a male with schizoaffective disorder. Aust N Z J Psychiatry 1995; 29(4): 683–7PubMedCrossRefGoogle Scholar
  77. 77.
    Leclercq P, Canivet JL, Damas P, et al. A case of severe hyponatremia under pimozide (Orap) administration. Rev Med Liege 1995; 50(4): 151–2PubMedGoogle Scholar
  78. 78.
    Landry P. Effect of risperidone on polydipsia and hyponatremia in schizophrenia. Can J Psychiatry 1995 Nov; 40(9): 566–7PubMedGoogle Scholar
  79. 79.
    Gupta S, Baker P. Clozapine treatment of polydipsia. Ann Clin Psychiatry 1994 Jun; 6(2): 135–7PubMedCrossRefGoogle Scholar
  80. 80.
    Assal F, Chauchot F. Hyponatremia of therapeutic origin: apropos of a case. Encephale 1994; 20(5): 527–9PubMedGoogle Scholar
  81. 81.
    Ellinas PA, Rosner F, Jaume JC. Symptomatic hyponatremia associated with psychosis, medications, and smoking. J Natl Med Assoc 1993 Feb; 85(2): 135–41PubMedGoogle Scholar
  82. 82.
    Suzuki M, Takeuchi O, Mori I, et al. Syndrome of inappropriate secretion of antidiuretic hormone associated with schizophrenia. Biol Psychiatry 1992 May 15; 31(10): 1057–61PubMedCrossRefGoogle Scholar
  83. 83.
    Ogilvie AD, Croy MF. Clozapine and hyponatraemia. Lancet 1992 Sep 12; 340(8820): 672PubMedCrossRefGoogle Scholar
  84. 84.
    Garcia Escrig M, Bermejo Pareja F, Soto Tellez O, et al. Neuroleptic malignant syndrome associated with the inadequate antidiuretic hormone secretion syndrome [in Spanish]. Arch Neurobiol (Madr) 1992; 55(2): 75–8Google Scholar
  85. 85.
    Nishikawa T, Tsuda A, Tanaka M, et al. Evidence for a direct adverse reaction of neuroleptics in self-induced water intoxication of psychiatric patients. Kurume Med J 1991; 38(4): 307–10PubMedCrossRefGoogle Scholar
  86. 86.
    Glusac E, Patel H, Josef NC, et al. Polydipsia and hyponatremia induced by multiple neuroleptics but not molindone. Can J Psychiatry 1990 Apr; 35(3): 268–9PubMedGoogle Scholar
  87. 87.
    Finlayson AJ, Vieweg WV, Wilkey WD, et al. Hypona-tremic seizure following ECT. Can J Psychiatry 1989 Jun; 34(5): 463–4PubMedGoogle Scholar
  88. 88.
    Mareth TR. Hyponatremia and schizophrenia: a case presentation. Mil Med 1988; 153(1): 40–1PubMedGoogle Scholar
  89. 89.
    Emsley RA, Taljaard JJ. Self-induced water intoxication: a case report. S Afr Med J 1988 Jul 16; 74(2): 80–1PubMedGoogle Scholar
  90. 90.
    Tormey WP, Cronin T, Devlin JD. Hyponatraemia masquerading as malignant neuroleptic syndrome [letter]. Br J Psychiatry 1987 Mar; 150: 412PubMedCrossRefGoogle Scholar
  91. 91.
    Kennedy MJ, Shelley RK, Daly PA. Potentiation of small cell lung cancer-related SIADH by trifluoperazine. Eur J Respir Dis 1987 Nov; 71(5): 450–4PubMedGoogle Scholar
  92. 92.
    Gibb WRG, Wedzicha JA, Hoffbrand BI. Recurrent neuroleptic malignant syndrome and hyponatraemia. J Neurol Neurosurg Psychiatry 1986; 49(8): 960–1PubMedCrossRefGoogle Scholar
  93. 93.
    Ananth J, Lin KM. SIADH: a serious side effect of psychotropic drugs. Int J Psychiatry Med 1986; 16(4): 401–7PubMedCrossRefGoogle Scholar
  94. 94.
    Wedzicha JA, Hoffbrand BI. Neuroleptic malignant syndrome and hyponatraemia [letter]. Lancet 1984 Apr 28; 1(8383): 963PubMedCrossRefGoogle Scholar
  95. 95.
    Kramer DS, Drake Jr ME. Assessment of SIADH in psychosis with a water-loading test: case report. J Clin Psychiatry 1984; 45(1): 40–1PubMedGoogle Scholar
  96. 96.
    Khamnei AK. Psychosis, inappropriate antidiuretic hormone secretion, and water intoxication [letter]. Lancet 1984 Apr 28; 1(8383): 963PubMedCrossRefGoogle Scholar
  97. 97.
    Tildesley HD, Toth E, Crockford PM. Syndrome of inappropriate secretion of antidiuretic hormone in association with chlorpromazine ingestion. Can J Psychiatry 1983 Oct; 28(6): 487–8 113PubMedGoogle Scholar
  98. 98.
    Kramer DS, Drake ME. Acute psychosis, polydipsia, and inappropriate secretion of anti-diuretic hormone. Am J Med 1983; 75(4): 712–4PubMedCrossRefGoogle Scholar
  99. 99.
    Gleadhill IC, Smith TA, Yium JJ. Hyponatremia in patients with schizophrenia. South Med J 1982 Apr; 75(4): 426–8PubMedCrossRefGoogle Scholar
  100. 100.
    Husband C, Mai FM, Carruthers G. Syndrome of inappropriate secretion of anti-diuretic hormone in a patient treated with haloperidol. Can J Psychiatry 1981; 26(3): 196–7PubMedGoogle Scholar
  101. 101.
    Weitzel WD, Shraberg D, Work J. Inappropriate ADH secretion: the role of drug re-challenge. Psychosomatics 1980; 21(9): 771–9PubMedGoogle Scholar
  102. 102.
    Nardelli E, Luzzani A. Water intoxication from fluphena-zine therapy. Ital J Neurol Sci 1980 Jun; 1(3): 193–6PubMedGoogle Scholar
  103. 103.
    Kosten TR, Camp W. Inappropriate secretion of anti-diuretic hormone in a patient receiving piperazine phenothiazines. Psychosomatics 1980 Apr; 21(4): 351, 354–5PubMedGoogle Scholar
  104. 104.
    Hamburger S, Langley H, Bowers G. The syndrome of inappropriate secretion of antidiuretic hormone associated with amitriptyline or trifluoperazine administration. J Kans Med Soc 1980 Oct; 81(10): 469–70PubMedGoogle Scholar
  105. 105.
    Caron C, Shooner K, Martineau M, et al. Water intoxication in a schizophrenic patient under treatment with thioridazine: study of the physiopathological mechanisms involved. Union Med Can 1979 Sep; 108(9): 1078–82PubMedGoogle Scholar
  106. 106.
    Vincent FM, Emery S. Antidiuretic hormone syndrome and thioridazine. Ann Intern Med 1978 Jul; 89(1): 147–8PubMedGoogle Scholar
  107. 107.
    Gipson WT, Price TR. Inappropriate ADH secretion in a psychiatric setting. Psychiatr Opin 1978; 15(7): 43–6Google Scholar
  108. 108.
    Cordoba OA, Chapel JL. Syndrome of inappropriate secretion of antidiuretic hormone (SIADH) secondary to antipsychotic drug therapy: case report. Mo Med 1978 Apr; 75(4): 177–8, 181PubMedGoogle Scholar
  109. 109.
    Matuk F, Kalyanaraman K. Syndrome of inappropriate secretion of antidiuretic hormone in patients treated with psychotherapeutic drugs. Arch Neurol 1977 Jun; 34(6): 374–5PubMedCrossRefGoogle Scholar
  110. 110.
    de Rivera JL. Inappropriate secretion of antidiuretic hormone from fluphenazine therapy [letter]. Ann Intern Med 1975 Jun; 82(6): 811–2PubMedGoogle Scholar
  111. 111.
    Rao KJ, Miller M, Moses A. Water intoxication and thioridazine (mellaril) [letter]. Ann Intern Med 1975 Jan; 82(1): 61PubMedGoogle Scholar
  112. 112.
    Fischman CM. Water intoxication and thioridazine [letter]. Ann Intern Med 1975 Jun; 82(6): 852PubMedGoogle Scholar
  113. 113.
    Logue DD, Gonzalez N, Heligman SDK, et al. Hyperglycemia in a 7-year-old child treated with aripiprazole. Am J Psychiatry 2007; 164(1): 173PubMedCrossRefGoogle Scholar
  114. 114.
    Niazy MN, Baidas G, Neyyarapally TI, et al. Severe diabetic ketoacidosis precipitated by an atypical anti-psychotic drug. Bahrain Med Bull 2007; 29(4): 143–5Google Scholar
  115. 115.
    Rodrigo Jarque I, Serrano Corredor S, Porras Obeso S, et al. Coexistence of neuroleptic malignant syndrome and syndrome of inappropiate antidiuretic hormone secretion in a patient with psychogenic polydypsia. Anales de Psiquiatria 1995; 11(6): 227–9Google Scholar
  116. 116.
    Adler S. Hyponatremia and rhabdomyolysis: a possible relationship. Southern Med J 1980; 73(4): 511–3PubMedCrossRefGoogle Scholar
  117. 117.
    Azuma H, Akechi T, Furukawa TA. Absence status associated with focal activity and polydipsia-induced hyponatremia. Neuropsychiatr Dis Treat 2008; 4(2): 495–8PubMedCrossRefGoogle Scholar
  118. 118.
    Bouizegarene P, Lamoril J, Deybach JC. An abdominal pain. Immuno-Analyse et Biologie Specialisee 2008; 23(5): 326–9CrossRefGoogle Scholar
  119. 119.
    Kohen I, Voelker S, Manu P. Antipsychotic-induced hyponatremia: case report and literature review. Am J Ther 2008 Sep–Oct; 15(5): 492–4PubMedCrossRefGoogle Scholar
  120. 120.
    Makhoul B, Hochberg I, Rispler S, et al. Dilated cardiomyopathy: an unusual complication of clozapine therapy. Nat Clin Pract Cardiovasc Med 2008 Sep; 5(9): 566–70PubMedCrossRefGoogle Scholar
  121. 121.
    Verre M, Bossio F, Mammone A, et al. Serotonin syndrome caused by olanzapine and clomipramine. Minerva Anestesiol 2008 Jan–Feb; 74(1–2): 41–5PubMedGoogle Scholar
  122. 122.
    Escribano Gonzaleza L, Nunez Martineza V, De Lorenzo-Caceres Ascanio A. Unspecific dizziness as form of presentation of syndrome of inappropriate antidiuretic hormone secretion. Formación Médica Continuada en Atención Primaria 2008; 15(2): 116–7 au123._Mannesse CK, van Puijenbroek EP, Jansen PAF, et al. Hyponatremia as adverse drug reaction of anti-psychotic drugs: a case-control study in VigiBase. Drug Saf. In pressCrossRefGoogle Scholar
  123. 124.
    Spigset O, Hedenmalm K. Hyponatraemia and the syndrome of inappropriate antidiuretic hormone secretion (SIADH) induced by psychotropic drugs. Drug Saf 1995 Mar; 12(3): 209–25PubMedCrossRefGoogle Scholar
  124. 125.
    Chan TYK. Drug-induced syndrome of inappropriate antidiuretic hormone secretion: causes, diagnosis and management. Drugs Aging 1997; 11(1): 27–44PubMedCrossRefGoogle Scholar
  125. 126.
    Spigset O, Wilhelmsson C, Mjörndal T, et al. Low serum sodium concentrations during treatment with citalopram in elderly patients: relationship to serum citalopram levels and to platelet serotonin 5-HT2A receptor status. J Clin Psychopharmacol 2000; 20(5): 582–4PubMedCrossRefGoogle Scholar
  126. 127.
    Blum A. The possible role of tobacco cigarette smoking in hyponatremia of long-term psychiatric patients. JAMA 1984; 252(20): 2864–5PubMedCrossRefGoogle Scholar
  127. 128.
    Tomson CR. Neuroleptic malignant syndrome associated with inappropriate antidiuresis and psychogenic polydipsia [letter]. Br Med J 1986 Jan 18; 292(6514): 171CrossRefGoogle Scholar
  128. 129.
    Looi JC, Cubis JC, Saboisky J. Hyponatremia, convulsions and neuroleptic malignant syndrome in a male with schizoaffective disorder. Aust N Z J Psychiatry 1995 Dec; 29(4): 683–7PubMedCrossRefGoogle Scholar
  129. 130.
    Lydakis C, Apostolakis S, Thalassinos E, et al. PIP syndrome: a potentially threatening manifestation of a psychiatric disorder. Int J Clin Pract 2005; 59(5): 612–3PubMedCrossRefGoogle Scholar
  130. 131.
    Vieweg WV, Carey RM, Godleski LS, et al. The syndrome of psychosis, intermittent hyponatremia, and polydipsia: evidence for diurnal volume expansion. Psychiatr Med 1990; 8(4): 135–44PubMedGoogle Scholar
  131. 132.
    Goldman MB, Luchins DJ, Robertson GL. Mechanisms of altered water metabolism in psychotic patients with polydipsia and hyponatremia. N Engl J Med 1988 Feb 18; 318(7): 397–403PubMedCrossRefGoogle Scholar
  132. 133.
    Goldman MB, Robertson GL, Luchins DJ, et al. The influence of polydipsia on water excretion in hyponatremic, 114 polydipsic, schizophrenic patients. J Clin Endocrinol Metab 1996 Apr; 81(4): 1465–70PubMedCrossRefGoogle Scholar
  133. 134.
    Luchins DJ, Nettles KW, Goldman MB. Anterior medial temporal lobe volumes in polydipsic schizophrenic patients with and without hypo-osmolemia: a pilot study. Biol Psychiatry 1997 Nov 1; 42(9): 767–70PubMedCrossRefGoogle Scholar
  134. 135.
    Goldman MB, Torres IJ, Keedy S, et al. Reduced anterior hippocampal formation volume in hyponatremic schizophrenic patients. Hippocampus 2007; 17(7): 554–62PubMedCrossRefGoogle Scholar
  135. 136.
    Hariprasad MK, Eisinger RP. SIADH in psychosis. J Clin Psychiatry 1980 Apr; 41(4): 148PubMedGoogle Scholar
  136. 137.
    Brunot A, Lachaux B, Sontag H, et al. Pharmaco-epidemiological study on antipsychotic drug prescription in French psychiatry: patient characteristics, antipsychotic treatment, and care management for schizophrenia. Encephale 2002 Mar–Apr; 28(2): 129–38PubMedGoogle Scholar
  137. 138.
    Linden M, Thiels C. Epidemiology of prescriptions for neuroleptic drugs: tranquilizers rather than anti-psychotics. Pharmacopsychiatry 2001 Jul; 34(4): 150–4PubMedCrossRefGoogle Scholar
  138. 139.
    Siegel AJ, Baldessarini RJ, Klepser MB, et al. Primary and drug-induced disorders of water homeostasis in psychiatric patients: principles of diagnosis and management. Harv Rev Psychiatry 1998 Nov–Dec; 6(4): 190–200PubMedCrossRefGoogle Scholar
  139. 140.
    Vieweg WV, David JJ, Rowe WT, et al. Death from self-induced water intoxication among patients with schizophrenic disorders. J Nerv Ment Dis 1985 Mar; 173(3): 161–5PubMedCrossRefGoogle Scholar
  140. 141.
    de Leon J, Tracy J, McCann E, et al. Polydipsia and schizophrenia in a psychiatric hospital: a replication study. Schizophr Res 2002 Oct 1; 57(2–3): 293–301PubMedCrossRefGoogle Scholar
  141. 142.
    de Leon J, Verghese C, Tracy JI, et al. Polydipsia and water intoxication in psychiatric patients: a review of the epidemiological literature. Biol Psychiatry 1994 Mar 15; 35(6): 408–19PubMedCrossRefGoogle Scholar
  142. 143.
    Gillum DM, Linas SL. Water intoxication in a psychotic patient with normal renal water excretion. Am J Med 1984 Oct; 77(4): 773–4PubMedCrossRefGoogle Scholar
  143. 144.
    Cadnapaphornchai MA, Summer SN, Falk S, et al. Effect of primary polydipsia on aquaporin and sodium transporter abundance. Am J Physiol Renal Physiol 2003 Nov; 285(5): F965–71PubMedGoogle Scholar
  144. 145.
    Hariprasad MK, Eisinger RP, Nadler IM, et al. Hyponatremia in psychogenic polydipsia. Arch Intern Med 1980 Dec; 140(12): 1639–42PubMedCrossRefGoogle Scholar
  145. 146.
    de Leon J, Dadvand M, Canuso C, et al. Polydipsia and water intoxication in a long-term psychiatric hospital. Biol Psychiatry 1996 Jul 1; 40(1): 28–34PubMedCrossRefGoogle Scholar
  146. 147.
    Ohsawa H, Kishimoto T, Shimayoshi N, et al. Atrial natriuretic peptide and arginine vasopressin secretion in schizophrenic patients. Acta Psychiatr Scand 1993 Aug; 88(2): 130–4PubMedCrossRefGoogle Scholar
  147. 148.
    Raskind M, Barnes RF. Water metabolism in psychiatric disorders. Semin Nephrol 1984; 4(4): 316–24Google Scholar
  148. 149.
    Raskind MA, Courtney N, Murburg MM, et al. Antipsychotic drugs and plasma vasopressin in normals and acute schizophrenic patients. Biol Psychiatry 1987 Apr; 22(4): 453–62PubMedCrossRefGoogle Scholar
  149. 150.
    Thomas A, Verbalis JG. Hyponatremia and the syndrome of inappropriate antidiuretic-hormone secretion associated with drug therapy in psychiatric patients. CNS Drugs 1995 Nov; 4(5): 357–69CrossRefGoogle Scholar
  150. 151.
    Vieweg WVR, Leadbetter RA. Polydipsia-hyponatraemia syndrome: epidemiology, clinical features and treatment. CNS Drugs 1997; 7(2): 121–38PubMedCrossRefGoogle Scholar
  151. 152.
    Verghese C, De Leon J, Simpson GM. Neuroendocrine factors influencing polydipsia in psychiatric patients: an hypothesis. Neuropsychopharmacology 1993 Sep; 9(2): 157–66PubMedGoogle Scholar
  152. 153.
    Malidelis YI, Panayotacopoulou MT, van Heerikhuize JJ, et al. Absence of a difference in the neurosecretory activity of supraoptic nucleus vasopressin neurons of neuroleptic-treated schizophrenic patients. Neuroendocrinology 2005; 82(2): 63–9PubMedCrossRefGoogle Scholar
  153. 154.
    Bersani G, Pesaresi L, Orlandi V, et al. Atypical anti-psychotics and polydipsia: a cause or a treatment? Hum Psychopharmacol 2007; 22: 103–7PubMedCrossRefGoogle Scholar
  154. 155.
    Wilke RA. Posterior pituitary sigma receptors and drug-induced syndrome of inappropriate antidiuretic hormone release [letter]. Ann Intern Med 1999 Nov 16; 131(10): 799PubMedGoogle Scholar

Copyright information

© Adis Data Information BV 2010

Authors and Affiliations

  • Didier Meulendijks
    • 1
    • 4
  • Cyndie K. Mannesse
    • 2
  • Paul A. F. Jansen
    • 3
  • Rob J. van Marum
    • 3
  • Toine C. G. Egberts
    • 1
    • 4
  1. 1.Pharmacoepidemiology and Pharmacotherapy, Utrecht Institute for Pharmaceutical Sciences (UIPS), Faculty of ScienceUtrecht UniversityUtrechtthe Netherlands
  2. 2.Department of Geriatric MedicineVlietland, Schiedamthe Netherlands
  3. 3.Department of Geriatric MedicineUniversity Medical Centre UtrechtUtrechtthe Netherlands
  4. 4.Department of Clinical PharmacyUniversity Medical Centre UtrechtUtrechtthe Netherlands

Personalised recommendations