Neurological complications caused by desmopressin in adults with nocturia

• Published in: Nederlands tijdschrift voor geneeskunde Vol. 155; no. 29; p. A3273
• Main Authors: Steendam, Christi M J, Vincent, Hieronymus H, Kastelijn, Elisabeth A
• Format: Journal Article
• Language: Dutch
• Published: Netherlands 2011
• Subjects: Aged, 80 and over; Deamino Arginine Vasopressin - adverse effects; Deamino Arginine Vasopressin - therapeutic use; Female; Humans; Hyponatremia - chemically induced; Male; Middle Aged; Nocturia - drug therapy
• ISSN: 0028-2162; 1876-8784

Desmopressin is occasionally used to reduce the frequency of nocturnal toilet visits. We describe an 86-year-old woman with nocturnal incontinence due to a urinary tract infection, and a 49-year-old man with frequent toilet visits in the night, known to consume excessive amounts of alcohol. They were admitted to hospital with neurological symptoms due to severe hyponatraemia, 114 and 102 mmol/l respectively, while using desmopressin. After the desmopressin had been discontinued and the fluid balance restored, they recovered completely. Hyponatraemia is inherent to the mechanism of action of desmopressin. Desmopressin should be prescribed only on sound indication, and risk factors for developing severe hyponatraemia should always be taken into consideration. Proper instruction and follow-up are important to prevent severe complications.