Polydipsia-Hyponatraemia Syndrome

摘要: The polydipsia-hyponatraemia syndrome (PHS) occurs in about 5 to 10% of institutionalised, chronically psychotic patients, 80% whom have schizophrenia. Major clinical features are polydipsia and dilutional hyponatraemia. Complications PHS include delirium, generalised seizures, coma death.Nonpharmacological interventions fluid restriction, diurnal bodyweight monitoring, behavioural approaches, supplemental oral sodium chloride administration. These require an experienced dedicated multidisciplinary staff.A number pharmacological treatments been assessed for including the combination lithium phenytoin, demeclocycline, propranolol, ACE inhibitors, selective serotonin (5-hydroxytryptamine; 5-HT) reuptake typical antipsychotic drugs, clozapine risperidone. Of these agents, most promising clozapine.Integrated treatment requires a highly informed staff, meticulous monitoring weight gain serum level, careful record keeping. Acute observation by trained water-free areas administration based on employing monthly chart base method. Intravenous hypertonic saline is used briefly administered controlled manner when patients with present seizures coma. Long term strategies clozapine.