Clin Psychopharmacol Neurosci.  2018 Feb;16(1):114-117. 10.9758/cpn.2018.16.1.114.

Polydipsia as a Precursor of Manic Episode in Bipolar Affective Disorder Patients with Alcohol Use Disorder

Affiliations
  • 1Department of Psychology, Vocational School of Health Services, Ãœsküdar University, Istanbul, Turkey.
  • 2Department of Philosophy, Vocational School of Health Services, Ãœsküdar University, Istanbul, Turkey.
  • 3Department of Medical Documentation and Secreteriat, Vocational School of Health Services, Ãœsküdar University, Istanbul, Turkey. onenunsalver@gmail.com

Abstract

Bipolar affective disorder (BD) diagnosis and initiation of appropriate treatment are often delayed, and this is associated with poorer outcomes, such as rapid cycling or cognitive decline. Therefore, identifying certain warning signs of a probable successive episode during the inter-episode phase is important for early intervention. We present the retrospective data of three cases of BD. Our first case had a history of alcohol use disorder (AUD), where he drank in a dipsomaniac manner, and the other two cases had dipsomaniac alcohol use before their manic attacks, and none of them had any AUD after the mood episode was over. Two brothers also had hypertensive episodes during the manic attacks. None of the cases reported increased fluid intake when they were euthymic. We suggest that polydipsia in BD may be a warning sign of an upcoming manic episode, especially in those patients with AUD. Polydipsia in BD may be caused or facilitated by a combination of hyperdopaminergic activity, hypothalamic dysfunction, and dysregulated renin-angiotensin system. To be able to prevent new episodes, a patient’s drinking habits and change in fluid intake should be asked at every visit. Those patients with a history of alcohol abuse should especially be informed about polydipsia and manic episode association.

Keyword

Polydipsia; Manic disorder; Binge drinking; Comorbidity; Alcoholism
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