Diabetes insipidus is a condition in which the body produces a large amount of dilute urine. Urine production is normally controlled by the kidneys, which in turn are regulated by a hormone known as antidiuretic hormone or vasopressin, which is secreted by the pituitary. A lack of antidiuretic hormone is referred to as central diabetes insipidus.
Vasopressin Stimulators
One way in which central diabetes insipidus can be treated is with medications that stimulate the production of vasopressin, the Merck Manual explains. Examples of these medications include carbemazepine, clofibrate and chlorpropamide. Paradoxically, a certain kind of diuretic, known as thiazide diuretics, can also be used in the treatment of central diabetes insipidus. All of these medications are able to take advantage of what is known as a feedback mechanism. When the pituitary is exposed to chemicals that have a diuretic effect on the body, it is naturally stimulated to produce vasopressin. These medications can be used to stimulate vasopressin release in order to treat mild to moderate cases of central diabetes insipidus.
Vasopressin
The other drug that can be used for the treatment of central diabetes insipidus is vasopressin, according to Drugs.com. The synthetic form of vasopressin is known as desmopressin and it in effect replaces the hormones that are not being produced in adequate amounts by the pituitary gland. Desmopressin can be taken orally in tablet form, but it can also be given as a nasal spray or as an injection. Patients receiving desmopressin treatment may need to be monitored for changes in the amount of fluids or electrolytes in the body because while the synthetic forms of vasopressin are effective at treating central diabetes insipidus, the dosage may need to be changed to meet the patient's fluid demands.
Desmopressin Considerations
Patients who are taking desmopressin for the treatment of central diabetes insipidus must be careful. Although regular desmopressin dosing can keep the body from becoming dehydrated, it can also disrupt the body's natural fluid balance, as MayoClinic.com notes. Consequently, patients receiving this form of treatment must drink water only when they feel thirsty to avoid overhydration. This is because the kidneys are less responsive to changes in fluid volume as a result of the administration of synthetic vasopressin.
