J Korean Soc Endocrinol.  2005 Aug;20(4):407-412. 10.3803/jkes.2005.20.4.407.

A Case of Drug Induced Nephrogenic Diabetes Insipidus and Hyperprolactinemia in Schizophrenia Simultaneously

• Ryu HY
• Lee MY
• Lee Y
• Koh JH
• Kim MJ
• Shin YG
• Chung CH

• KMID: 2100474
• DOI: http://doi.org/10.3803/jkes.2005.20.4.407

Abstract

In schizophrenia, when treatment using antipsychotics fails, lithium, which is known as an antimanic drug, can also be administered. It is reported that 12~20% of patients taking lithium develop nephrogenic diabetes lactotrophs. Hyperprolactinemia is induced by typical antipsychotics, as they block the dopamine-2 receptors of latotrophs in the pituitary gland. Therefore, atypical antipsychotics for decreasing the side effect, such as hyperprolactinemia, can be used. However, hyperprolactinemia can be induced by risperidone, one of the atypical antipsychotics. Here, a case of drug induced nephrogenic diabetes insipidus and simultaneous hyperprolactinemia, which occurred in a patient with schizophrenia, is reported.

MeSH Terms

Antipsychotic Agents
Diabetes Insipidus, Nephrogenic*
Humans
Hyperprolactinemia*
Lactotrophs
Lithium
Pituitary Gland
Risperidone
Schizophrenia*
Antipsychotic Agents
Lithium
Risperidone

Figure

• 

  Fig. 1 Sellar MRI Contrst. No gross abnormality. A. T1 Image coronal view. B. T2 Image coronal view

Reference

2. Martin A. Clincal management of lithium-induced polyuria. Hosp Community Psychiatry. Psychiatry. 1993. 44:427–428.

3. Wells BG. Amiloride in lithium-induced polyuria. Ann Pharmacother. 1994. 28:888–889.

4. Molitsh M, Reichlin S. The amenorrhea, galactorrhea and hyperprolactinemia syndrome. Adv Intern Med. 1980. 26:37–65.

5. Marken PA, Haykal RF, Fisher JN. Management of psychotropic-induced hyperprolactinemia. Clin Pharm. 1992. 11:851–856.

6. De Coster R. clinical research report R6476617. Effect of single oral dose administration of rosperidone on plasma prolactin, growth hormone, and cortisol levels in healthy male volunteers. 1988. Beerse, Belgium: Janssen Research Foundation.

7. Alan J, Ellen L, Stephen C. The prationer's guide to psychoactive drug. 1991. 3rd ed. New York: Plenum Medical Company;96–99.

8. Williams WO, Gyory AZ. Aspects of the use of lithium for the non-psychiatrist. Aust N Z J Med. 1976. 6:233–242.

9. Boton R, Gaviria M, Batlle DC. Prevalance, pathogenesis and treatment of renal dysfunction associated with chronic lithium therapy. Am J Kidney Dis. 1987. 10:329–345.

10. Passavanti G, Buongiorno E, De Fino G, Rutigliano G, Giannattasio M, Coratelli P. Lithium induced polyuria and polydipsia. Adv Exp Med Biol. 1989. 252:215–231.

11. Zito JM, Sofair JB, Jaeger J. Self-reported neuroendocrine effects of antipsychotics in women: apilot study. DICP. 1990. 24:176–180.

12. Kuruvilla A, Peedicayil J, Srikrishna G, Kuruvilla K, Kanagasabapathy A. A study of serum prolactin levels in schizophrenia: comparison of males and females. Clin Exp pharmacil Physiol. 1992. 19:603–606.

13. Gelder Y, De Coster R, Woestenbrorghs C. Clinical Research Report R64766/1. First clinical experience with R64766, a new antipsychotic. 1987. Beerse Belgium: Janssen Research Foundation.

14. Dickson RA, Dalby JT, Williams R, Edward AL. Risperidone-induced prolactin elevations in premenopausal women with schizophrenia. Am J Psychiatry. 1995. 152:1102–1103.

15. Casey DE. Clozapine: neuroleptic induced EPS and tardive dyskinesia. Psychopharmacology. 1989. 99:Suppl. S47–S53.

16. Philip S, Teresa T. Rapid relaease of antipsychotic drugs from dopamine D₂ receptors: An explanation for low receptor occupancy and early clinical relapse upon withdrawal of clozapine or quetiapine. Am J Psychiatry. 1999. 156:876–884.

17. Farde L, Nyberg S, Oxentierna G, Nakashima Y, Halldin C, Ericsson B. Position emission tomography studues on D2 and 5HT2 receptor binding in risperidone treated schizoprenic patients. J Clin Psychopharmacology. 1995. 15:Suppl. 19–23.

18. Schiwach RS, Carmody TJ. Prolactogenic effects of risperidone in male patients. Acta Psychiatry Scand. 1998. 98:81–83.

19. Baptista T, Zarate J, Joober R, Colasante C, Beaulieu S, Paez X, Hernandez L. Drug induced weight gain, an impediment to successful pharmacotherapy: focus on antipsychotics. Curr Drug Targets. 2004. 5:279–299.

20. Guirguis AF, Taylor HC. Nephrogenic diabetes insipidus persisting 57 months after cessation of lithium carbonate therapy: report of a case and review of the literature. Endocr Pract. 2000. 6:324–328.