A 55-year-old man with schizophrenia developed water intoxication due to primary polydipsia. His manner of antidiuretic hormone secretion was investigated by water loading and infusion of hypertonic saline to clarify the form of the syndrome of inappropriate antidiuretic hormone secretion. The plasma antidiuretic hormone level, which may be involved in the occurrence of water intoxication, was consistently low in this patient, and linked to type D syndrome of inappropriate antidiuretic hormone secretion, designated "hypovasopressinemic antidiuresis". Although this type is not common, it should be considered as a pathophysiology for water intoxication in schizophrenia patients.
Keywords: hyponatremia; plasma osmolality; polydipsia; schizophrenia; water intoxication.