Last reviewed: July 2019
Last updated: May  2019

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors
  • water-seeking and drinking

Other diagnostic factors

  • polyuria
  • headache or nausea
  • lethargy or confusion
  • seizures, delirium, or coma

Risk factors

  • mental illness
  • anxious, middle-aged women
  • developmental disability disorders
  • smoking

Diagnostic investigations

1st investigations to order

  • plasma osmolality
  • urine osmolality
  • urine sodium
  • serum sodium
  • 24-hour urine volume
  • urinalysis
  • serum urea
  • water restriction test
Full details

Investigations to consider

  • vasopressin test
  • plasma antidiuretic hormone
  • CXR
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Shilpa Srinivasan

Associate Professor of Clinical Psychiatry

Department of Neuropsychiatry and Behavioral Science

University of South Carolina School of Medicine

Columbia

SC

Disclosures

SS is a board member of the American Association for Geriatric Psychiatry and serves on the Geriatric Psychiatry Exam Committee for the American Board of Psychiatry and Neurology.

Meera Narasimhan

Chair of the Department of Neuropsychiatry

Department of Neuropsychiatry and Behavioral Science

University of South Carolina School of Medicine

Columbia

SC

Disclosures

MN is a member of an advisory board for Alkermes.

Dr Shilpa Srinivasan and Dr Meera Narasimhan would like to gratefully acknowledge Dr Emily Williams and Dr Brian Dundas, previous contributors to this topic. EW and BD declare that they have no competing interests.

Peer reviewers VIEW ALL

Assistant Clinical Professor of Child Psychiatry

Yale School of Medicine

Medical Director of Psychiatry

Clifford W. Beers Guidance Clinic

New Haven

CT

Disclosures

PJvW declares that he has no competing interests.

Neuropsychiatric Hospital "Dr Ivan Barbot"

Popovaca

Croatia

Disclosures

BM is an author of a reference cited in this topic.

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