Potomania is a thirst disorder causing excessive consumption of fluids, especially water. Some potomaniacs can absorb up to 24 liters of water per day when the normal average consumption is 1,5 liters. Two types of potomania can be distinguished. Primary potomania, often of a psychological nature, generates excessive consumption independent of a physiological need. Secondary potomania triggers real thirst and is due to a biological cause.

Definition of potomania

Potomania is a thirst disorder causing excessive consumption of fluids, especially water.

A person is considered a potomaniac when he consumes more than three liters per day, all liquids combined – excluding solid food. Some potomaniacs can absorb up to 24 liters of water per day.

Types de potomanies

Two types of potomania can be distinguished:

• Primary potomania, also called psychogenic diabetes insipidus or primary psychogenic polydipsia – excessive thirst – is characterized by a chronic compulsion to ingest enormous amounts of fluid, most often water. Patients drink before they are really thirsty;
• Secondary potomania is linked to a biological cause.

Causes of potomania

Potomania can be caused by:

• Undiagnosed diabetes: this situation causes the accumulation of sugar in the blood and is characterized by an inability of the kidneys to concentrate the urine, leading to polyuria – release of too much fluid in the urine – accompanied by a intense thirst;
• Genetic causes resulting in the absence of the hormone regulating water in the kidney, vasopressin, or a dysfunction of the kidney itself, then resistant to the action of this hormone. This is called diabetes insipidus;
• Side effects of certain drugs causing dry mouth;
• Certain mental illnesses such as schizophrenia or anorexia nervosa – the phenomenon of potomania is very occasional for this last category and intended to reach a given mass without intake of calories;
• Neurological disorders in certain areas of the hypothalamus – a region of the brain responsible for, among other things, the regulation of thirst;
• Infantile neuroses and psychoses.

Diagnosis of potomania

The diagnosis of potomania is based first of all on the anamnesis – reconstruction of the pathological history of the patient by means of his memories and those of his entourage: the doctor questions the patient on the reasons for his excessive thirst, the quantities of ingested liquid, frequencies… potomaniacs whose cause is psychological or psychiatric, for example drink a lot during the day but not at night when potomaniacs whose cause is biological drink day and night. On the other hand, potomaniacs for biological reasons drink because they are thirsty while others drink before they are thirsty.

In order to rule out secondary biological potomania, doctors perform a water deprivation test. The patient should not drink for a few hours and the practitioner observes the concentration of water in the urine and sodium –salt– in the blood plasma. Diabetic or diabetic patients with insipidus experience an increase in their water concentration in the urine and an increase in their sodium level in the plasma. It is then a question of treating the biological cause.

People affected by potomania

In its major form, potomania is very rare. 4% of schizophrenics are potomaniacs but the causes of this potomania remain hypothetical.

Factors favoring potomania

Certain factors can favor the occurrence of potomania:

• Early conditioning in infants;
• Anxieties;
• Age: from 60 years, the risk increases;
• Taking ecstasy – by acting on proteins involved in water regulation but also via excessive hydration recommended during the evenings;
• Automatisms of alcohol consumption behavior: some beer drinkers stop eating and drink only beer… It is a particular form of potomania;
• Mental retardation;
• And many more

hyponatremia

Potomania leads to too much water in the blood leading to a decrease in the amount of sodium –sodium– in the blood. This situation is called hyponatremia: it is a hydroelectrolyte disorder defined by a sodium concentration in the blood plasma below 135 mmol / l.

Swelling

The whole body swells due to the accumulation of water distributed throughout the body.

Brain edema

Under the effect of the accumulation of water, the brain swells but is limited by the skull: this is cerebral edema. This extreme situation, which can lead to death, occurs when large amounts of water are absorbed over a very short period of time.

Other symptoms

Epileptic attacks;

Neurological disorders.

Treatment for potomania depends on its cause:

• If the cause is psychic, psychotherapy is required;
• If it is biological, the primary disease must be treated: diabetes, diabetes insipidus, etc. ;
• Finally, if it is related to a given treatment, stopping the treatment – or its substitution – should be considered by the doctor.

Difficult to prevent potomania… On the other hand, if your daily intake of fluids exceeds three liters, consult your doctor in order to eliminate the problem as quickly as possible.