demeclocycline and Psychotic-Disorders

Eight patients (7 men and 1 woman, mean age 43.1 +/- 8.9 years) with psychosis, intermittent hyponatremia, and polydipsia (PIP syndrome) underwent treatment with demeclocycline in an effort to normalize serum sodium levels and thereby protect the PIP patients against complications including hyponatremic seizures and coma. There tended to be an improvement (p = .080) in early morning serum sodium following treatment with demeclocycline (baseline 132.6 +/- SD 3.3 and treatment serum sodium 134.8 +/- SD 3.3 mEq/1). At the same time, there was an increase (p = .043) in urinary specific gravity following treatment with demeclocycline (baseline 1.0047 +/- SD .0029 and treatment urinary specific gravity 1.0063 +/- SD .0026). Clinical indications for and potential mechanisms of action of demeclocycline treatment in the PIP syndrome are discussed.

Topics: Adult; Clinical Trials as Topic; Demeclocycline; Drinking; Female; Humans; Hyponatremia; Male; Middle Aged; Psychotic Disorders; Sodium; Syndrome

A case of tuberculous Addison's disease presenting with psychosis, profound hyponatraemia, and detectable plasma antidiuretic hormone is reported. Clinical and biochemical improvement after corticosteroid replacement was followed by relapse with further psychosis and inappropriate antidiuretic hormone secretion: both were promptly reversed by demethylchlortetracycline. The association of psychological symptoms with Addison's disease, the role of anti-diuretic hormone secretion in Addison's disease, and the inter-relationship between Addison's disease, psychosis and anti-diuretic hormone secretion are discussed.

Topics: Addison Disease; Body Weight; Demeclocycline; Fludrocortisone; Humans; Hydrocortisone; Inappropriate ADH Syndrome; Male; Middle Aged; Psychotic Disorders; Vasopressins; Water Intoxication