Treatment of Psychogenic Polydipsia With Acetazolamide: A Report of 5 Cases

Objective: Psychogenic polydipsia occurs frequently in patients with chronic psychiatric illness and is often unmanageable. We herein report 5 patients in whom acetazolamide was trialed for this symptom. Methods: We encountered a case in which polydipsia improved with incidental administration of acetazolamide. We then used this treatment for 4 additional cases of treatment-resistant psychogenic polydipsia, some of which were accompanied by hyponatremia. Results: Acetazolamide improved polydipsia and/or hyponatremia in 4 of the 5 cases. This treatment was well tolerated and allowed 3 of the patients to permanently leave isolation. Conclusion: Acetazolamide appears to have a beneficial effect in psychogenic polydipsia.