The Potomania is An impulsive desire to drink water all the time and can have very serious consequences. People who suffer from it usually drink between six and ten or Fifteen liters of water per day.
Potomania could also be defined as a disorder in the control of impulses, characterized by excessive water intake. Occurs frequently In patients with schizophrenia Or other chronic psychiatric illnesses.
But the good news is that this disorder can be cured with proper treatment. To learn more about this condition, continue reading this interesting article.
Causes of potomania
Actually potomania can be triggered by several factors, including the following:
Alteration in the functioning of the hypothalamus. He Hypothalamus Is a region of the brain that regulates hunger and thirst among other basic functions. An alteration in the Functioning of this region could trigger an episode of potomania.
Underlying psychiatric diseases. Certain mental illnesses, such as schizophrenia, Anxiety disorders , Major depression , Bipolar disorder And delirious pictures increase The risk of suffering from this condition.
Certain diseases , as the diabetes , Can cause a great sensation of thirst accompanied by an excessive intake of liquids.
Some patients with Anorexia nervosa Can present potomania: they often use water intake as a way to quench Without adding calories or momentarily increasing your body weight before going to a medical appointment, for example.
Certain medications, Such as nonsteroidal anti-inflammatory drugs and anticholinergic drugs, can also cause episodes of potomania.
When there is no organic cause for this condition and the origin is strictly psychological or psychiatric, potomania happens to be called polydipsia Psychogenic.
Symptoms of potomania
The main symptoms are the compulsive desire to drink water and excessive fluid intake, which exceeds four liters of water per day.
Yes one Person is consuming more than six liters per day, you should consult your doctor immediately, even if no other symptoms appear.
In patients with potomania there may also be a great feeling of anxiety, trouble sleeping, panic attacks Y Headaches .
Consequences of potomania
If treatment is not received, potomania can have very serious consequences and may even lead to the death of the patient.
When a person drinks too much fluid, the kidneys are not able to eliminate excess urine.
Therefore, the water is diluting the blood and lowering the concentrations of sodium, potassium and chlorine, which are very important for the operation Of the whole organism.
It is estimated that approximately 10% to 20% of patients with potomania have low levels of sodium in the blood.
This alteration in the concentration of ions in blood can cause:
Muscle cramps.
Sickness.
Headache.
Swelling in the joints of the legs.
Heart failure.
Confusion, depression of consciousness.
Hallucinations.
Paralysis.
Convulsions.
Coma.
Death.
For this reason it is very important that anyone who is drinking more than four liters of water daily, consult the doctor immediately.
Potomania Treatments
The treatment of potomania can vary according to its cause.
If the disorder is caused by diabetes , The treatment of this disease with medication and an adequate diet should reduce the permanent sensation of Thirst in the patient.
If potomania is caused by any medication, the doctor may look for alternative drugs.
And in the case of patients with mental disorders, the treatment of psychogenic polydipsia includes the following pillars: restriction of Fluid intake, psychological therapy, drug therapy and correction of hyponatremia (low sodium level), if any.
Correction of Hyponatremia
In most cases of psychogenic polydipsia sodium remains at normal levels, but in 10% or 20% of cases, there may be hyponatremia Mild, moderate or severe.
Symptoms of hyponatremia may go undetected, unless the sodium concentration decreases rapidly.
Typically, hyponatremia in patients with potomania is mild or moderate and asymptomatic, especially if there is no other underlying disease than Affect blood sodium levels.
Severe and symptomatic hyponatremia can occur in less than 48 hours without the fluid intake being much higher than usual, and the consequences Decrease in the level of sodium in the blood can be harmful, causing Cerebral edema , Seizures, coma, and death.
That is why it is important to correct the patient's sodium levels, if they are low.
A hypertonic solution (3% sodium chloride), which is applied intravenously, is usually used for correction. The correction must Be made slowly, because if the sodium level rises too fast, there can also be very negative consequences.
Restriction of liquids
As you might expect, the first thing to do when someone has potomania is to restrict their fluid intake.
At the beginning of the restriction, the patient should consume between 0.8 and 1.5 liters of water every 24 hours. A way to know if a person has been drinking Too much water during the day is controlling body weight.
If you drink a lot of water, your weight will increase to 2.2%.
Psychological therapy
The problem with fluid restriction is that many patients with potomania are not able to comply with it, precisely because of that, because they feel An uncontrollable desire to drink water.
In extreme cases, confinement of the patient may be necessary in an area that lacks water sources.
Through Behavioral therapy , The therapist can apply some tools and techniques to bring about changes in the behavior of the Patient and in this way Decrease anxiety You feel if you do not drink water.
For example, the patient is given a 500 ml jug and told to only fill it six times in the day. When you feel like drinking, you can Small sips, or you can try to distract yourself with other things so you do not drink more than you should.
In some cases, the Rewards system With some success. For example, if the patient meets the goal of not Drinking more than one liter of water in the day, you are assigned tokens or points. And if it does not comply, they will be taken away.
As therapy advances, the therapist attempts to modify the patient's thoughts, fears, and false beliefs about water intake.
Positive reinforcement of appropriate behaviors and the therapist's tools to deal with anxiety often work well.
Throughout the treatment, the patient is asked to Keep a diary In which he notes what happened to him, how he felt and how much water he drank, each time I needed to drink liquid
After 12 weeks of treatment, potomania should be under control.
Pharmacological therapy
In cases of psychogenic polydipsia, atypical antipsychotics, usually prescribed in patients with schizophrenia, bipolar disorder, depression Major and other mental illnesses, have proved to be quite effective for potomania as well.
Clozapine. In a 6-week study in which the evolution of 8 patients with schizophrenia who had potomania was monitored, Good results with this medicine.
Risperidone. It is another antipsychotic that can be used to relieve psychogenic polydipsia.
On the other hand, if the patient has potomania due to a mental disorder such as major depression for example, the urge to drink water can be controlled Spontaneously when the patient is receiving treatment for his underlying disease.
Three real cases of potomania
It is always interesting to know actual cases of these conditions that seem strange, but which may actually be more frequent than you think.
Case number 1. Potomania associated with major depression and panic attacks
In a hospital in India, a 25-year-old divorced and low socioeconomic woman was shown taking 12 to 25 liters of water Daily (true, even if you can not believe it!).
The lady also suffered attacks of panic, anxiety, crying crisis, headaches and problems sleeping for about 3 years. Also had asthenia , Poor concentration And depressed mood.
In her medical history there was no history of psychiatric illness, or anything flashy except for an unhappy marriage that had ended some time behind.
In this case, despite the large water intake, sodium remained at normal levels.
Doctors determined that the woman had psychogenic polydipsia and also major depression. The symptoms of potomania disappeared after a brief Period of fluid restriction and treatment with Benzodiazepines , Antidepressants And psychotherapy.
Case number 2. Potomania caused by a drug
An 18-year-old boy was referred to the psychiatric service of a Spanish hospital because of his behavioral alterations, which included episodes of Aggression towards their parents.
In his medical history there was no history of mental illness, however, in his life the boy had always had problems relating and Low performance in school.
After some studies, doctors determined that I had low IQ and had intermittent explosive disorder, and Prescribed a drug called topiramate, used for the treatment of epilepsy and migraine among other conditions.
With this medication, in four weeks they transmitted the boy's aggressive symptoms, but he started suddenly to drink about 5 liters of water newspapers. The only possible explanation for this change in behavior was a side effect of the drug.
Doctors decided to withdraw topiramate and symptoms of potomania completely relapsed in only 4 days.
While it is not known exactly how topiramate works, it is known to alter the functioning of sodium channels in neurons. This could cause Elevated levels of sodium in the blood and lead to potomania in the patient.
Case number 3. Potomania with severe hyponatremia
A 41-year-old man, who had suffered from paranoid schizophrenia since he was 16 years old and was on haloperidol (antipsychotic medication) Irregular, was taken one day to the emergency service of a hospital with seizures.
The relatives said that for two years had taken more than 5 liters of water daily and that he had been drowsy and nauseated for two or three days . That day they found him lying on the floor, convulsing, and they took him to the hospital.
In this case, the sodium level was very low, only 119 mEq per liter, when the normal level is above 135 mEq per liter. Surely this Such a low sodium level was the cause of the seizures, as other possible causes were ruled out.
The sodium level was corrected with intravenous hypertonic solution, and within two days the symptoms of water intoxication had completely subsided.
As you can see, potomania can have several causes, but whatever it is, it is a condition that must be treated.
If you know someone who is drinking more than four liters of water every day, or this happens to you, you should consult the doctor right away, you could Be saving your life or that of someone very dear.
What is your experience with potomania? Your experience will help other readers. Thanks!