Role of Naltrexone in Improving Compulsive Drinking in Psychogenic Polydipsia

Abstract

Psychogenic polydipsia or self-induced water intoxication is a potentially lethal condition seen in many chronic psychiatric patients. This is a literature review based on therapeutic significance of Naltrexone in improving compulsive water drinking behavior in chronic psychiatrically ill patients with psychogenic polydipsia. Naltrexone is an opioid antagonist approved by FDA for alcohol dependence. Extensive literature search provides a line of evidence that suggests correlation of opioid receptor with compulsive water ingestion in animals. However, there is limited data regarding clinical utility of naltrexone in improving psychogenic polydipsia in human species. This review highlights the necessity for further research and trials to elucidate the role of naltrexone in human psychogenic drinking behavior.

An unquenchable thirst

“…However, studies have been small and inconsistent. 8,9 Propranolol, 10 a beta adrenergic receptor blocker; irbesartan, 11 an angiotensin-II receptor blocker; demeclocycline, 12 a tetracycline that inhibits antidiuretic hormone action; and naltrexone, 9 a mu opioid antagonist, have been studied with inconclusive results and a variety of adverse effects 5,7,13 (Table 2 [8][9][10][11][12][13] ).…”

“…The theory is that the continuous urge to drink water of psychogenic polydipsia is akin to addictive behaviors, which have shown positive response to blocking opioid receptors 9 Alpha-2-antagonist (mianserin)…”