Abstract

COMPULSIVE DRINKING OF WATER produces no symptoms other than polyuria and perhaps manifestations of an underlying psychiatric disturbance.1–3 However, if the usual mechanisms for excreting water are compromised these patients may occasionally develop acute hyponatremic encephalopathy, manifested by decreased levels of consciousness, seizures, coma, irreversible brain damage, and even death.4.5Treatment with thiazide diuretics has been associated with impaired free water clearance and acute hyponatremic states in psychogenic water drinkers.2.6 Two such cases were recently seen at the Little Rock Veterans Administration Hospital (LRVAH).