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Paliperidone-induced Polydipsia in Schizophrenia

Yi-Ting Hsieh, Yi-Yung Hung, Tiao-Lai Huang

Objective: Polydipsia is an underdiagnosed clinical phenomenon among pa- tients with chronic schizophrenia. Detection and management of polydipsia are clinically important because of its complications such as severe hyponatremia and water intoxication, resulting in epilepsy, coma, and death. The effect of antipsy- chotic drugs can cause polydipsia remains controversial. Case Report: We report a 37-year-old male patient taking paliperidone (12 mg per day) for chronic schizo- phrenia. After a three-week treatment with paloperidone, he developed polydipsia (daily water intake being greater than 10 liters) and hyponatremia. He did not have any other medical causes. We switched paliperidone to olanzapine (20 mg per day) due to suspected paliperidone-induced polydipsia. His daily water intake was de- creased to 5 liters after two weeks, and all other associated symptoms were sub- sided. No relapse of polydipsia was noted in the following six months. Conclu-sion: Polydipsia may be related to paliperidone use. Further investigation of its cause relationship is needed.
Key Word Paliperidone, polydipsia, hyponatremia, antipsychotic
Editorial Committe, Taiwanese Journal of Psychiatry
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