There are several types of diabetes insipidus (DI), an uncommon condition that occurs when the kidneys are unable to conserve water during their job of filtering blood. Therefore, excessive urination (polyuria) occurs; the amount of water conserved is controlled by antidiuretic hormone (ADH), also called vasopressin. People experience extreme thirst (polydipsia). Diagnosis may be straightforward or may require special tests blood and urine tests.
Diabetes insipidus caused by a lack of ADH — antidiuretic hormone produced in the hypothalamus in the brain and then released by the pituitary — is called central diabetes insipidus and is determined by testing. One test involves an infusion of a synthetic analog of AVP called desmopressin acetate (DDAVP). Patients who show more highly concentrated urine in response to DDAVP may have central or neurogenic diabetes insipidus or pituitary diabetes insipidus. Those who don’t respond to DDAVP may have nephrogenic diabetes insipidus.
Commonly Prescribed (On-Label) Drugs: None
Off-Label Prescription Drugs Breakthrough Options: Carbamazepine, Indapamide
When diabetes insipidus is caused by failure of the kidneys to respond to ADH, the condition is called nephrogenic diabetes insipidus. ADH is produced in a region of the brain called the hypothalamus, then stored and released from the pituitary gland, at the base of the brain. Many tests are performed to diagnose nephrogenic diabetes insipidus. Experts from the Kutato Laboratorium wrote in Orv Hetil that the differential diagnostics of central diabetes, nephrogenic, and dipsogenic diabetes insipidus sometimes seems enigmatic.
Commonly Prescribed (On-Label) Drugs: None
Off-Label Prescription Drugs Breakthrough Options: Amiloride, Ethacrynic acid, Indapamide, Indomethacin, Bendroflumethiazide, Chlorothalidone, Hydrochlorothiazide, Hydroflumethiazide, Metolazone
Experts from Northwestern University note in an article in Diabetes Insipidus that a patient may have a partial form of any one of the types of diabetes insipidus. This has led to the creation of another category of partial central diabetes insipidus. The demarcation — and name — of the third category seems to change depending on which study one is reading.
Commonly Prescribed (On-Label) Drug: Phenobarbital
Off-Label Prescription Drugs Breakthrough Options: Carbamazepine, Chlorpropamide
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