Polydipsia

 Have you ever worked out without drinking enough fluids and gotten dehydrated? Feeling ill and faint and maybe even passing out are some of the symptoms of dehydration, but did you know that there is such a thing as over-hydration? Drinking water in excess can also cause adverse side effects to your body. In this paper I’ll be discussing water intoxication, what causes it, how to diagnose and treat it and finally, the effects of ecstasy and water intoxication.

 So what exactly is Polydipsia? Polydipsia, also known as Hyponatremia, is defined as the excessive drinking of water and excessive thirst, fairly common symptoms, are often reactions to fluid lost during exercise, excessive sweating (excessive loss of salt and water), or excessive salt intake. There are also causes of polydipsia such as drug induced-dehydration, which I will discuss in more detail later. The causes of polydipsia should begin with the history of the syndrome.

The earliest recorded reports of the syndrome of polydipsia date back to the first quarter of this century. At this time professors began examining the effects of excessive water intake on the human brain and also on animals. Since this time Polydipsia has been recorded in millions of people around the world.

“The syndrome of polydipsia has been reported in psychiatric patients, specifically, for three quarters of a century. The link between polydipsia and mental illnesses is still being investigated today.

Although the history of polydipsia is almost a century long the cause is still somewhat of a mystery today.

 “The human body maintains an equilibrium of electrolytes including salt in the bloodstream as part of it’s normal operation. Sweating causes the body to lose salt and when a person drinks excessive amounts of water it dilutes the salt in the body to a dangerous level. Unfortuanatley as the electrolytes get out of balance, body systems start to fail and (because of the blood brain barrier), the sufferer starts to exhibit signs of crisis as their brain begins to swell. This swelling is called a ‘brain edema’ or ‘cerebral edema’ and can (and does) lead to brain damage, paralysis, and death.

One theory of the cause of polydipsia is that it may be produced by a number of disease states, most commonly by syndrome of inappropriate antidiuretic hormone secretion (SIADH), but also by excessive NaCl loss, as in diarrhea and vomiting, renal disease, and Addison’s disease.

 Polydipsia has been reported heavily among people with mental illnesses. “The most recent study done by Sleeper and Jellinek of 360 schizophrenics revealed the prevalence of polydipsia to be 26% in hospitalized psychiatric patients. Interestingly, Sleeper and Jellinek found that patients with higher intelligence quotients and less emotional deterioration were less likely to progress to water intoxication that were patients with high premorbid functioning and positive symptoms.”

Other studies have shown that “80% of polydipsic patients have schizophrenia and that males are more frequently afflicted than females.” Although the studies prove that people afflicted with mental illnesses are more likely to experience polydipsia, it is possible that polydipsia could be caused by setting rather than state of mind. Most of the studies were done on institutionalized patients, therefore polydipsia could be related to institutionalization rather than mental illness. Without studying the causes of polydipsia further we may never know why people with mental illnesses tend to experience polydipsia as well.

 “Young woman dies of water intoxication after taking one tablet of ecstasy. Today’s drug panorama calls for increased vigilance in health care…”

            The above headline concerns the “case report of a 20-year-old previously healthy Swedish girl. She died of water intoxication and cerebral edema approximately 24 hours after ingestion of one tablet of ecstasy at a rave club in Amsterdam.

            Ecstasy or MDMA is a popular club drug in today’s nightlife of raves and all-night parties. The drug itself has been linked to many physical problems and psychological addiction, however it’s link to the problem of water intoxication is recently coming to light.

            “One of the persistent problems with ecstasy use is that of hyperthermia (heat stroke/over-heating). Several factors contribute to this effect, including MDMA’s pharmacological effect of increasing body temperature, the strong physical stimulation experienced by most users, and the euphoria and comfort of the experience which can cause users to overlook their level of exertion” As a result of the overdoses that have been caused by ecstasy, in which temperatures of the victims have reached 113 degrees several hours after death, ravers who experiment with this popular club drug are now being urged to drink plenty of water when on ecstasy. It has been hoped that this excessive amount of water intake would counteract the effects of hyperthermia, but sadly, users who drink lots of water while on ecstasy don’t consider the dangers of over-hydration or polydipsia.

            “According to C. Haller, MD from the CaliforniaPoisonControlCenter in San Francisco, polydipsia is one of the most common causes of ecstasy deaths or serious injuries."

 “The dangers of drinking water obsessively while high are real. If you’re drinking water, in any context, mixing in some salty snacks or drinking sport drinks will keep your salt and electrolyte levels healthier and can prevent polydipsia. People on ecstasy very often don’t want to eat anything, so salty snacks tend to be an ineffective option. However, when your life is on the line, reaching for a pretzel or two couldn’t hurt.