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Severe Hyponatraemia Due to Water Intoxication in a Schizophrenic Patient

A 57-year-old patient with schizophrenia and epilepsy presented to the emergency department with clinical signs of severe hyponatraemia. The patient was incontinent of urine and neurological signs were present; she was eventually transferred to the high dependency unit (HDU). Several causes for the low sodium were considered, but the discovery of a large number of empty water bottles in the patient's home confirmed the suspected diagnosis of water intoxication during a psychotic state. The patient's plasma sodium levels were restored over the course of several days and she was eventually transferred home uneventfully.