Havens Thomas H, Innamorato Gaetano, Nemec Eric C
Sacred Heart University, College of Health Professions, 5151 Park Ave, Fairfield, CT 06825, United States of America.
J Psychosom Res. 2022 Jan;152:110674. doi: 10.1016/j.jpsychores.2021.110674. Epub 2021 Nov 20.
Polydipsia is defined at the intake of excessive fluid (>3 L daily). Psychogenic polydipsia (PPD) presents without an identifiable medical cause and is often seen in patients with diagnoses of schizophrenia, OCD, anxiety, alcohol use disorder, and other psychotic disorders. The purpose of this systematic review is to assess the therapeutic effect of various non-antipsychotic medications on patients with a stable psychotic illness and concurrent PPD.
A systematic search was conducted using the following databases: PubMed, MEDLINE with Full Text, CINAHL complete, Cochrane database of systematic reviews, Cochrane methodology register, MasterFILE Premier, APA PsychArticles, APA PsychInfo, APA PsycBooks, APA PsycTests, TRIP, Nursing and Allied Health. The quality of each retained study was assessed using appropriate risk of bias tools based on study design.
The initial search resulted in 1422 articles from which 22 articles were included for qualitative synthesis. Study designs ranged from case reports to double blind, placebo controlled randomized trials and was interpreted uniquely based on study design. Acetazolamide was effective in improving some PPD outcomes. Fluoxetine at high doses was effective in reducing fluid intake and polydipsia. Other medications included in this review performed equivocally for reduction of numerous parameters evaluating PPD.
No one drug appeared to be the most efficacious; however, some did show promise in specific populations. Those in need of pharmacotherapeutic options for PPD may consider one of the included agents to assist with co-morbid state. Further high-quality research is needed to provide better treatment guidance for PPD.
烦渴定义为摄入过量液体（每日>3升）。精神性烦渴（PPD）无明确的医学病因，常见于精神分裂症、强迫症、焦虑症、酒精使用障碍及其他精神障碍患者。本系统评价的目的是评估各种非抗精神病药物对患有稳定精神疾病并发PPD患者的治疗效果。
使用以下数据库进行系统检索：PubMed、全文版MEDLINE、CINAHL完整版、Cochrane系统评价系统评价数据库、Cochrane方法学注册库、MasterFILE Premier、美国心理学会心理学全文数据库、美国心理学会心理学文摘数据库、美国心理学会心理学书籍数据库、美国心理学会心理测试数据库、TRIP、护理学与联合健康数据库。根据研究设计，使用适当的偏倚风险工具评估每项纳入研究的质量。
初步检索得到1422篇文章，其中22篇文章纳入定性综合分析。研究设计从病例报告到双盲、安慰剂对照随机试验不等，并根据研究设计进行了独特的解读。乙酰唑胺在改善某些PPD结局方面有效。高剂量氟西汀在减少液体摄入量和烦渴方面有效。本综述中纳入的其他药物在降低评估PPD的众多参数方面表现不一。
似乎没有一种药物是最有效的；然而，有些药物在特定人群中确实显示出前景。需要药物治疗PPD的患者可考虑使用其中一种药物来辅助治疗共病状态。需要进一步开展高质量研究，为PPD提供更好的治疗指导。
