Appropriate Correction of Hyponatremia in a Patient With Psychogenic Polydipsia: A Case Report

Hyponatremia, a common electrolyte imbalance characterized by low serum sodium values, can range from mild, asymptomatic cases to life-threatening conditions. Complex etiologies, such as psychiatric disorders, may complicate the presentation and treatment modalities utilized. Additionally, treatment strategies must be personalized, as rapid correction of hyponatremia can lead to severe complications such as osmotic demyelination syndrome (ODS). This case report examines a 69-year-old male with a history of schizophrenia and chronic psychogenic polydipsia who presented with severe hyponatremia, serum sodium 115 mmol/L (millimoles per liter), and associated symptoms. The patient's condition was complicated by the risk of osmotic demyelination syndrome (ODS) due to the rapid correction of sodium levels. A careful management strategy using dextrose 5% in water (D5W) and desmopressin (DDAVP) was employed to gradually correct his sodium levels and prevent ODS. This case highlights the importance of differentiating between acute and chronic hyponatremia and adhering to correction protocols to avoid dangerous overcorrection. Ultimately, this case reinforces the need for multidisciplinary collaboration, attentive monitoring, and individualized treatment strategies in managing hyponatremia in patients with underlying psychiatric conditions.