Summer heat and a caution about fluidsJuly 9th, 2010 by gelenberg Leave a reply »
More thoughts triggered by summer’s heat. Hydration is good—usually. A couple of exceptions, however, apply to folks with chronic mental illness.
Occasional people who have chronic psychosis drink enough water to drop their serum sodium and risk seizures, coma, and death. Most likely, the mental illness itself somehow manages to impair the usual feedback loop that turns down antidiuretic hormone and maintains proper fluid balance. Antipsychotics also may contribute. The resulting syndrome of inappropriate antidiuretic hormone (SIADH) often is diagnosed following a seizure and usually requires assessment of medications and restriction of fluid intake.
More common in people with mental illness is consumption of calorie-laden beverages, with resultant weight gain and sometimes dental caries and gum disease. As I wrote in another recent blog, encourage the chronically ill to stay well hydrated—especially in hot weather. But the best fluid is plain water, sometimes made more appealing with a slice of fruit or cucumber. Sugared beverages should be discouraged, as they can lead to weight gain and its many long-term consequences, like diabetes mellitus. Diet soft drinks have been found to spur increased desire for sweets, thus paradoxically leading to weight gain. Water and seltzer are far better for
long-term health than sodas and even juices.