Nephrogenic diabetes insipidus in a lethargic lithium-treated patient

Neth J Med. 1997 Mar;50(3):105-9. doi: 10.1016/s0300-2977(96)00082-4.


We report on a patient who developed severe lithium-induced nephrogenic diabetes insipidus (NDI) and neurotoxicity, despite recommended serum lithium levels. Hydrochlorothiazide and indomethacin appeared effective antipolyuric drugs, which led to a normalization of serum osmolality. After re-initiating lithium therapy, with lithium levels around 0.3 mmol/l, recurrence of NDI or neurotoxicity was not observed, despite discontinuation of indomethacin and hydrochlorothiazide. Together with hypothyroidism, NDI and neurotoxicity must be considered in lethargic lithium-treated patients.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Aged, 80 and over
  • Antidepressive Agents / adverse effects*
  • Antidepressive Agents / therapeutic use
  • Brain / drug effects
  • Diabetes Insipidus, Nephrogenic / blood
  • Diabetes Insipidus, Nephrogenic / chemically induced*
  • Humans
  • Lithium / blood
  • Lithium Carbonate / adverse effects*
  • Lithium Carbonate / therapeutic use
  • Male
  • Mood Disorders / drug therapy*
  • Sleep Stages*


  • Antidepressive Agents
  • Lithium Carbonate
  • Lithium