Neuroendocrine factors influencing polydipsia in psychiatric patients: An hypothesis

Cherian Verghese, Jose De Leon, George M. Simpson

Research output: Contribution to journalArticlepeer-review

61 Scopus citations


Polydipsia and water intoxication cause considerable morbidity and mortality in chronic psychiatric patients. The pathophysiology of the disorder is unknown, and there is no effective treatment. Angiotensin II is an important dipsogen in animals; in humans, some conditions with abnormal thirst are associated with increased angiotensin function. Chronic D2 dopamine receptor blockade increases angiotensin II-induced thirst in animals; in humans, increased peripheral response to angiotensin II is documented. Chronic D2 blockade withtypical neuroleptics may increase sensitivity to angiotensin II and induce thirst. Clozapine, which has negligible D2 blocking action may improve polydipsia. Recent case reports demonstrate improvement of polydipsia during clozapine therapy. Angiotensin II releases vasopressin; this could explain water intoxication, which occurs later in the syndrome. This paper suggests an etiological model and a treatment modality for this disorder.

Original languageEnglish
Pages (from-to)157-166
Number of pages10
Issue number2
StatePublished - Sep 1993


  • Angiotensins
  • Atrial natriuretic peptide
  • Hyponatremia
  • Polydipsia
  • Vasopressin

ASJC Scopus subject areas

  • Pharmacology
  • Psychiatry and Mental health


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