{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T01:54:27Z","timestamp":1777946067374,"version":"3.51.4"},"reference-count":8,"publisher":"Springer Science and Business Media LLC","issue":"2","license":[{"start":{"date-parts":[[2020,2,11]],"date-time":"2020-02-11T00:00:00Z","timestamp":1581379200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2020,2,11]],"date-time":"2020-02-11T00:00:00Z","timestamp":1581379200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"University of Innsbruck and Medical University of Innsbruck"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Neuropsychiatr"],"published-print":{"date-parts":[[2020,6]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p>In the literature, several cases of an association between hyponatremia and psychotic symptoms have been reported. We present the case of a\u00a0young Caucasian male presenting with rapid, incoherent speech, religious and megalomanic delusions, and emotional lability. The patient was described by his relatives as being healthy until a\u00a0few days before admission. He had no significant medical or psychiatric history, except a\u00a0short drug-induced psychotic episode a\u00a0few years earlier. Somatic workup showed moderate hyponatremia, but no other abnormalities. Tests for narcotics, in particular, were also negative. Antipsychotic treatment with risperidone was initiated. After normalization of sodium levels using intravenous saline, the patient remitted within a\u00a0few days and risperidone was discontinued on day\u00a03. He was discharged by day\u00a013 without further pharmacological treatment.<\/jats:p><jats:p>Dysfunction of voltage-gated ion channels, particularly sodium and calcium channels, has been implicated in the pathogenesis of bipolar disorder. We therefore assume a\u00a0causal relationship between hyponatremia and manic-psychotic symptoms in our patient. Hyponatremia was most likely induced by excessive water intake during a\u00a0period of fasting in the context of a\u00a0wellness practice.<\/jats:p>","DOI":"10.1007\/s40211-020-00335-z","type":"journal-article","created":{"date-parts":[[2020,2,11]],"date-time":"2020-02-11T14:02:51Z","timestamp":1581429771000},"page":"85-87","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Case report: manic episode with psychotic symptoms induced by hyponatremia","Fallbericht: Hyponatri\u00e4mie-induzierte manische Episode mit psychotischen Symptomen"],"prefix":"10.1007","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3642-6340","authenticated-orcid":false,"given":"Laurin","family":"Mauracher","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria","family":"Rettenbacher","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2020,2,11]]},"reference":[{"key":"335_CR1","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1155\/2015\/512430","volume":"2015","author":"JDL Farah","year":"2015","unstructured":"Farah\u00a0JDL, Lauand\u00a0CV, Chequi\u00a0L, Fortunato\u00a0E, Pasqualino\u00a0F, Bignotto\u00a0LH, et\u00a0al. Severe psychotic disorder as the main manifestation of adrenal insufficiency. Case Rep Psychiatry. 2015;2015:1\u20134.","journal-title":"Case Rep Psychiatry"},{"key":"335_CR2","doi-asserted-by":"publisher","DOI":"10.1530\/EDM-16-0147","author":"V John","year":"2017","unstructured":"John\u00a0V, Evans\u00a0P, Kalhan\u00a0A. Delayed dyskinesia and prolonged psychosis in a\u00a0patient presenting with profound hyponatraemia. Endocrinol Diabetes Metab Case Rep. 2017. https:\/\/doi.org\/10.1530\/EDM-16-0147.","journal-title":"Endocrinol Diabetes Metab Case Rep"},{"issue":"11","key":"335_CR3","first-page":"1","volume":"10","author":"S Parag","year":"2018","unstructured":"Parag\u00a0S, Espiridion\u00a0ED. Hyponatremia presenting with recurrent mania. Cureus. 2018;10(11):1\u20135.","journal-title":"Cureus"},{"issue":"6","key":"335_CR4","first-page":"1","volume":"95","author":"CH Yang","year":"2016","unstructured":"Yang\u00a0CH, Lin\u00a0YC, Chou\u00a0PH, Chen\u00a0HC, Chan\u00a0CH. A case report of late onset mania caused by hyponatremia in a\u00a0patient with empty Sella syndrome. Medicine. 2016;95(6):1\u20132.","journal-title":"Medicine"},{"issue":"1","key":"335_CR5","doi-asserted-by":"publisher","first-page":"18","DOI":"10.1016\/j.tins.2017.10.006","volume":"41","author":"PJ Harrison","year":"2018","unstructured":"Harrison\u00a0PJ, Geddes\u00a0JR, Tunbridge\u00a0EM. The emerging neurobiology of bipolar disorder. Trends Neurosci. 2018;41(1):18\u201330.","journal-title":"Trends Neurosci"},{"issue":"3","key":"335_CR6","doi-asserted-by":"publisher","first-page":"298","DOI":"10.1111\/j.1399-5618.2007.00429.x","volume":"9","author":"X Huang","year":"2007","unstructured":"Huang\u00a0X, Lei\u00a0Z, El-mallakh\u00a0RS. Lithium normalizes elevated intracellular sodium. 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Philadelphia: Wolters Kluwer Health; 2015. pp.\u00a0522\u20139.","edition":"6"}],"container-title":["neuropsychiatrie"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s40211-020-00335-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1007\/s40211-020-00335-z\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s40211-020-00335-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,2,10]],"date-time":"2021-02-10T07:49:12Z","timestamp":1612943352000},"score":1,"resource":{"primary":{"URL":"http:\/\/link.springer.com\/10.1007\/s40211-020-00335-z"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,2,11]]},"references-count":8,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2020,6]]}},"alternative-id":["335"],"URL":"https:\/\/doi.org\/10.1007\/s40211-020-00335-z","relation":{},"ISSN":["0948-6259","2194-1327"],"issn-type":[{"value":"0948-6259","type":"print"},{"value":"2194-1327","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,2,11]]},"assertion":[{"value":"30 August 2019","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 January 2020","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"11 February 2020","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Compliance with ethical guidelines"}},{"value":"L.\u00a0Mauracher and M.\u00a0Rettenbacher declare that they have no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"Written informed consent of the patient was obtained.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical standards"}}]}}