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Query: UMLS:C0036341 (
schizophrenia
)
60,220
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
Review of 60 consecutive records of patients who died before the age of 53 years in a state mental hospital revealed that 27 of those patients (45%) had a schizophrenic disorder. Of those 27 patients, five (18.5%) died of the complications of self-induced
water
intoxication and
schizophrenic disorders
(SIWIS). Clinical, laboratory, and autopsy features of those five SIWIS patients and of an additional five SIWIS cases obtained from the literature include psychosis, polydipsia, polyuria, severe hyposthenuria (specific gravity 1.003 or less), hyponatremia, seizures, coma, and cerebral and visceral edema. SIWIS characteristically develops during Arieti's third or "preterminal" stage (5 to 15 years after onset of psychosis) of
schizophrenic disorders
and it must be included in the differential diagnosis of unexplained death among psychiatric patients. As there are no pathognomonic SIWIS tissue changes, the pathologist must carefully integrate clinical, laboratory, and autopsy findings to arrive at the proper diagnosis. When premortem findings of polydipsia and hyponatremia are not available, evidence of antecedent severe hyposthenuria and postmortem vitreous humor hyponatremia of less than 120 mEq/1 are strongly supportive of the diagnosis of death due to SIWIS.
...
PMID:Death from self-induced water intoxication among patients with schizophrenic disorders. 397 77
Ten patients (8 men, 2 women; mean age 38.7 +/- 8.1 years), 7 of whom had
schizophrenic disorders
and 3 of whom had bipolar disorder (manic-depressive illness), manifested psychosis, intermittent hyponatremia, and polydipsia (PIP syndrome). The relationship between serum sodium and urinary
water
excretion among the 10 PIP patients is described in detail. The success of lithium in improving serum sodium levels and in decreasing urinary
water
excretion among the three PIP patients with bipolar disorder and the failure of changes in urinary
water
excretion to explain changes in serum sodium levels among the 10 PIP patients argue against "psychogenesis" as the explanation for the polydipsia and excessive
water
intake as the sole explanation for hyponatremia or complications ascribed to
water
intoxication.
...
PMID:Psychogenic polydipsia and water intoxication--concepts that have failed. 406 21
Although there is a definite association between hyponatremia and
schizophrenia
, the true incidence and etiology have not been established. This report is a retrospective study of all admissions to the Baroness Erlanger Hospital over a three and one-half year period. There was a 5.8% incidence of hyponatremia in patients with
schizophrenia
as compared with a 0.36% incidence for all admission (P less than .01). Schizophrenic patients at risk for developing hyponatremia drank
water
excessively(P less than .01) and were most likely to be taking thioxanthene (P = .05(4)) antipsychotic and anticholinergic medications (P Less than .01). Most schizophrenic patients admitted with hyponatremia had dangerously low serum sodium levels (less than or equal to 120 mEq) and showed severe neurologic dysfunction. This retrospective study compares the clinical features of schizophrenic patients who develop hyponatremia and those who do not. The possible role of antidiuretic hormone is discussed
...
PMID:Hyponatremia in patients with schizophrenia. 612 72
The complications of
water
intoxication are well documented in the medical literature. Less well appreciated is the frequent appearance of self-induced
water
intoxication in patients with
schizophrenic disorders
. Six such patients are described and compared with the findings in the literature. Nonedematous, nonhypovolemic hyponatremia is the invariable biochemical abnormality in this syndrome and its multiple causes are discussed, including the syndrome of inappropriate antidiuresis. Severe hyposthenuria (urinary specific gravity 1.003 or less) is the silent biological marker that always antedates the complications of self-induced
water
intoxication and
schizophrenic disorders
(SIWIS). While recognizing that all patients with polydipsia do not go on to develop
water
intoxication, this biological marker provides the means to detect patients who may be destined to develop SIWIS; early recognition may prevent the major complications of this syndrome.
...
PMID:Evaluation of patients with self-induced water intoxication and schizophrenic disorders (SIWIS). 647 Jun 99
Four patients with the syndrome of self-induced
water
intoxication and
schizophrenic disorders
, as well as inappropriate antidiuresis, are described. In each case, severe hyposthenuria preceded the clinical symptoms by 1 to 7 years. Hyposthenuria may be a marker for this syndrome.
...
PMID:Hyposthenuria as a marker for self-induced water intoxication and schizophrenic disorders. 648 63
Rats were treated chronically with haloperidol (1.5 mg/kg per day in drinking
water
) for up to 9 months. At 1 week, 3.5 months and 9 months after commencing treatment, spontaneous activity in separate groups was depressed by 30-40%. Apomorphine stereotypy was also attenuated at 9 months. Following a 7-10 day withdrawal period after 9 months of treatment, both measures were elevated. Enhancement of spontaneous activity appeared to be at least in part characterised by a deficit in psychomotor habituation to the test apparatus. DA receptor blockade during haloperidol treatment for a substantial proportion of a rat's adult life was found to be an enduring effect, paralleling its antipsychotic action. Developing neurochemical supersensitivity was only manifested behaviourally after withdrawal of neuroleptic. The implications of such findings for the pathophysiology of
schizophrenia
and tardive dyskinesia and for the functional significance of dopamine receptor heterogeneity are discussed.
...
PMID:Neuroleptic treatment for a substantial proportion of adult life: behavioural sequelae of 9 months haloperidol administration. 719 33
Compulsive water drinking (psychogenic polydipsia) is a well-recognized clinical entity that is often seen in individuals with psychiatric disorders, especially
schizophrenia
. Although urinary tract abnormalities including enlarged bladders and hydronephrosis have been reported, the presence of chronic renal failure is rarely reported in this disorder. We report four patients with psychogenic polydipsia who presented with chronic renal failure due to obstructive uropathy in the absence of demonstrable anatomic causes of obstruction. The likely mechanism of functional obstructive uropathy is bladder failure due to a combination of excessive
water
ingestion, enlarged bladder volumes, and use of anticholinergic medications.
...
PMID:Compulsive water drinking in the setting of anticholinergic drug use: an unrecognized cause of chronic renal failure. 757 11
Phencyclidine (PCP), in a dose of 15 mg/kg, produced delayed cognitive dysfunction (at 24 h) in rats subjected to
water
maze tasks. At 24 h after PCP administration, ataxia, hyperlocomotion and stereotyped behavior were not induced. NE-100, N,N-dipropyl-2-[4-methoxy-3-(2-phenylethoxy)phenyl]-enthylamine monohydrochloride, a selective and potent sigma receptor ligand, was administered orally 10 min after PCP administration or 15 min before the first trial (24 h after PCP administration). In both cases, NE-100 dose-dependently attenuated the delayed cognitive dysfunction induced by PCP. As these findings show that ingestion of PCP led to delayed cognitive dysfunction similar to the cognitive signs of psychosis seen in humans, NE-100 is being further studied for possible treatment of subjects with
schizophrenia
.
...
PMID:Effect of NE-100, a novel sigma receptor ligand, on phencyclidine- induced delayed cognitive dysfunction in rats. 760 28
The use of psychotropic drugs has been associated with the syndrome of inappropriate antidiuretic hormone secretion (SIADH) in a number of case reports. SIADH is characterised by the sustained release of antidiuretic hormone (ADH) from the posterior pituitary. The patients have a reduced ability to excrete diluted urine, ingested fluid is retained, and the extracellular fluid expands and becomes hypo-osmolar. The cardinal signs are hyponatraemia, serum hypoosmolality and a less than maximally diluted urine. Common symptoms include weakness, lethargy, headache, anorexia and weight gain. These symptoms may be followed by confusion, convulsions, coma and death. The early symptoms are vague and nonspecific, and they may even mimic the symptoms of the psychiatric disorder itself. For antidepressants, the risk of SIADH seems to be highest during the first weeks of treatment. For antipsychotics, the risk seems to be more spread out in time. The causative role of the drug may sometimes be difficult to estimate, as even drug-free psychiatric patients, mostly those with
schizophrenia
, develop SIADH on the basis of psychogenic polydipsia. Smoking is another factor associated with the development of SIADH, and the risk may also increase with age. The acute treatment of SIADH induced by a psychotropic drug includes discontinuation of the drug as well as restriction of fluid intake. In cases with significant clinical symptoms, infusion of sodium chloride is recommended. After the acute management, it is useful to evaluate the causative role of the drug by performing a
water
loading test and/or drug rechallenge. If continued treatment with an antidepressant or antipsychotic is indicated, a drug with a different pharmacological profile should be chosen, and the serum sodium levels should be monitored closely. If treatment with the drug that caused SIADH must be continued, concomitant treatment with demeclocycline may reduce the tendency of hyponatraemia.
...
PMID:Hyponatraemia and the syndrome of inappropriate antidiuretic hormone secretion (SIADH) induced by psychotropic drugs. 761 32
1. Phencyclidine (PCP) reduces the latency of rats diving into a
water
-filled pool from a hidden platform, without stereotyped behavior. 2. The sigma-selective ligand, NE-100 (N,N-dipropyl-2-[4-methoxy-3-(2-phenylethoxy)phenyl]-ethyl-amine monohydrochloride), attenuates the effects of PCP in this procedure. 3. The serotonin2 (5-HT2) antagonist, ritanserin, and the sigma receptor ligands, 1-(cyclopropylmethyl)-4-[2'(4"-fluorophenyl)-2'-oxoethyl]- piperidine HBr (Dup734), 4-[2'-(4"-cyanophenyl)-2'-oxoethyl]-1- (cyclopropylmethyl)piperidine (XJ448), alpha-(4-fluorophenyl)-4-(5-fluoro-2-pyrimidinyl)-1-piperazine butanol (BMY14802) and rimcazole similarly attenuate the effects of PCP. 4. The dopamine D2/sigma ligands, haloperidol and cis-N-(1-benzyl-2-methyl-pyrrolidin-3-yl)-2-methoxy-5-chloro-4- methylaminobenzamide (YM-09151-2) completely reverse the effects of PCP, whereas the same dose ranges of these drugs produce sedation. 5. The dopamine D2-selective antagonist, sulpiride, has no apparent effect on the PCP latency to the rat dive. 6. Thus, PCP-induced diving behavior was improved by sigma ligands and the 5-HT2 antagonist. This model of negative symptoms in an experimental animal will facilitate experiments on drug treatments for
schizophrenia
.
...
PMID:The sigma-selective ligand NE-100 attenuates the effect of phencyclidine in a rat diving model. 771 58
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