ASCP Corner: Reconsidering Chronic Hyponatremia in Psychosis

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The introduction of vasopressin-receptor antagonists (vaptans), along with new information regarding morbidity and mortality, has stimulated a reconsideration of the importance of chronic hyponatremia in psychotic patients. Hyponatremia (serum sodium concentration < 136 mEq/L) is the most common electrolyte disorder seen in psychotic patients, with prevalence rates ranging from 7%–10% among inpatients.

The presence of hyponatremia seldom evokes much concern among mental health professionals unless an acute drop in serum sodium level leads to frank neurologic symptoms.

J Clin Psychiatry 2013;74(3):278-279