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Is propranolol effective in primary polydipsia?

Y Kishi1, H Kurosawa, S Endo

  • 1Department of Psychiatry, Nippon Medical School, Chiba Hokusoh Hospital, Japan.

International Journal of Psychiatry in Medicine
|December 9, 1998
PubMed
Summary
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Propranolol effectively reduced excessive water intake in psychiatric patients with polydipsia by potentially inhibiting the renin-angiotensin system. This beta-blocker offers a promising new treatment avenue for managing this challenging condition.

Area of Science:

  • Psychiatry
  • Pharmacology
  • Nephrology

Background:

  • Polydipsia in psychiatric patients is challenging to manage with standard interventions.
  • The renin-angiotensin system, involving angiotensin II, is hypothesized to play a role in pathological water drinking.
  • Beta-blockers can inhibit renin release, potentially impacting angiotensin II levels.

Observation:

  • Three eunatremic but polydipsic patients were studied.
  • Two patients had a history of hyponatremia requiring emergency treatment.
  • Previous fluid restriction had been ineffective in controlling water intake.

Findings:

  • Propranolol administration led to significant reductions in fluid intake in two out of three patients.
  • One patient's intake decreased from over 7000 ml to approximately 3000 ml.

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  • A third patient showed a significant decrease in body weight, suggesting reduced fluid retention.

    • Implications:

    • Propranolol may be a viable therapeutic option for treating polydipsia in psychiatric patients, particularly those with schizophrenia.
    • The efficacy of propranolol could be linked to its action on the renin-angiotensin system.
    • Further controlled clinical trials are necessary to validate these preliminary findings and establish propranolol's role in polydipsia management.