de Leon J, Verghese C, Stanilla J K, Lawrence T, Simpson G M
Medical College of Pennsylvania, Eastern Pennsylvania Psychiatric Institute, Philadelphia 19129, USA.
Neuropsychopharmacology. 1995 Apr;12(2):133-8. doi: 10.1016/0893-133X(94)00069-C.
Polydipsia occurs frequently in chronic schizophrenic patients, some of whom develop intermittent hyponatremia. Most therapeutic efforts have tried to control the hyponatremia. Four schizophrenic patients, followed for more than one year, showed improvement on clozapine. Case 1 was an outpatient without history of hyponatremia who improved from polydipsia and psychosis. The last three were inpatients with polydipsia, intermittent hyponatremia, and psychosis who showed minimal improvement of psychosis but significant decrease in polydipsia and water intoxication. Case 2 relapsed to polydipsia when clozapine was discontinued on two occasions. Case 3 demonstrated polyuria during 39% of days before clozapine and in 0% of days after two weeks of clozapine. In case 4, most baseline sodium levels were abnormal, but all became normal after clozapine. A time-series analysis for intervention effects showed a significant effect of clozapine (p = .017). The limited information provided by these case reports suggest the need for controlled studies of the clozapine effect on polydipsic patients.
多饮症在慢性精神分裂症患者中经常出现，其中一些患者会发展为间歇性低钠血症。大多数治疗措施都试图控制低钠血症。对4例精神分裂症患者进行了一年多的随访，结果显示氯氮平治疗有效。病例1是一名门诊患者，无低钠血症病史，多饮症和精神病症状均有改善。后3例为住院患者，有 多饮症、间歇性低钠血症和精神病症状，精神病症状改善不明显，但多饮症和水中毒症状显著减轻。病例2在两次停用氯氮平后复发多饮症。病例3在服用氯氮平前39%的日子里出现多尿，服用氯氮平两周后多尿天数为0%。病例4的大多数基线钠水平异常，但服用氯氮平后均恢复正常。干预效果的时间序列分析显示氯氮平有显著效果（p = .017）。这些病例报告提供的信息有限，提示有必要对氯氮平对多饮症患者的疗效进行对照研究。
