Clozapine restores water balance in schizophrenic patients with polydipsia-hyponatremia syndrome

Carla M. Canuso, Morris B. Goldman*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

13 Scopus citations


Hyponatremia/hypoosmolemia causes marked morbidity and prolongs hospital stays in a significant subset of schizophrenic patients. Case reports with methodological limitations suggest clozapine ameliorates this water imbalance. To more conclusively assess this possibility, we completed a 24-week open-label study in 8 male polydipsic hypoosmolemic schizophrenic inpatients. Subjects were treated initially for 6 weeks with a conventional neuroleptic, which was replaced by 300, 600, and 900 (if tolerated) mg/day of clozapine for sequential 6-week periods. On clozapine, mean plasma osmolality rose an average of 15.2 mosm/kg (95% CI : 5.5-25.0). Dosage of 300 mg/day of clozapine was sufficient to normalize plasma osmolality and was generally well tolerated. Clozapine appears to be the first effective pharmacotherapy for severe water imbalance in schizophrenia.

Original languageEnglish (US)
Pages (from-to)86-90
Number of pages5
JournalJournal of Neuropsychiatry and Clinical Neurosciences
Issue number1
StatePublished - Jan 1 1999

ASJC Scopus subject areas

  • Clinical Neurology
  • Psychiatry and Mental health


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