Nonhormonal Drugs in Cranial Diabetes Insipidus Treatment
Although use of nonhormonal drugs (Fig. 5.20) has been recommended in the past, their high incidence of significant side effects and limited antidiuretic effect have restricted their use. Chlorpropamide appears to act by increasing renal tubular sensitivity to circulating endogenous vasopressin, while carbamazepine probably increases vasopressin secretion. These drugs are suitable only for patients with partial cranial diabetes insipidus, who still secrete vasopressin but in insufficient quantities. The mechanism of action of thiazide diuretics is probably related to the reduction in extracellular sodium and decreased glomerular filtration. All oral preparations reduce the polyuria by twenty-five to fifty per cent.
