Harvard review of psychiatry · 2008
Hyponatremia in psychiatric patients: update on evaluation and management.
СтатьяОбзорНазвание и аннотация: Перевод в очереди
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Siegel Arthur J
Аннотация
BACKGROUND: Hyponatremia (serum sodium concentration < 136 mEq/L) is a prevalent and potentially dangerous medical comorbidity in psychiatric patients.
METHODS: MEDLINE was used to identify peer-reviewed publications that described the role of arginine vasopressin (AVP) in the pathogenesis of hyponatremia, the presentation and treatment of hyponatremia in psychiatric patients, and promising new treatment options.
RESULTS: Polydipsia may lead to hyponatremia in patients with schizophrenia, which is mediated, in part, by a reduced osmotic threshold for the release of AVP and by a defect in the osmoregulation of thirst. Acute-onset hyponatremia may require emergent treatment with hypertonic (3%) saline, whereas chronic cases mandate gradual correction to minimize the risk of osmotic demyelination. The AVP-receptor antagonists, including conivaptan, tolvaptan, lixivaptan, and satavaptan, represent a therapeutic advance in the treatment of dilutional hyponatremia.
CONCLUSION: Based on the role of AVP in the development of hyponatremia, further studies are warranted to determine the efficacy of the AVP-receptor antagonists in psychiatric patients with hyponatremia.
METHODS: MEDLINE was used to identify peer-reviewed publications that described the role of arginine vasopressin (AVP) in the pathogenesis of hyponatremia, the presentation and treatment of hyponatremia in psychiatric patients, and promising new treatment options.
RESULTS: Polydipsia may lead to hyponatremia in patients with schizophrenia, which is mediated, in part, by a reduced osmotic threshold for the release of AVP and by a defect in the osmoregulation of thirst. Acute-onset hyponatremia may require emergent treatment with hypertonic (3%) saline, whereas chronic cases mandate gradual correction to minimize the risk of osmotic demyelination. The AVP-receptor antagonists, including conivaptan, tolvaptan, lixivaptan, and satavaptan, represent a therapeutic advance in the treatment of dilutional hyponatremia.
CONCLUSION: Based on the role of AVP in the development of hyponatremia, further studies are warranted to determine the efficacy of the AVP-receptor antagonists in psychiatric patients with hyponatremia.