Neurogenic Diabetes Insipidus: Management with dDAVP (1-Desamino-8-D Arginine Vasopressin)

Abstract

DDAVP, an analogue of arginine vasopressin with high antidiuretic and low vasopressor potency, was used to treat 29 patients with neurogenic diabetes insipidus for up to 22 mo. Intranasal dDAVP, 2.5-15 .mu.g twice daily, provided excellent control in most patients. Individual responses were independent of age, weight and severity of diabetes insipidus. Resistance to dDAVP may be a rare complication of prolonged therapy. Two patients with acute postoperative diabetes insipidus were effectively treated with 5 .mu.g of dDAVP every 14-18 h. Compared to previous therapy, side effects of dDAVP were minimal (headaches in 2 patients), and control of symptoms and urine volume was as good as with vasopressin tannate in oil or better than chlorpropamide and lysine vasopressin nasal spray. Intranasal dDAVP, because of efficacy, long duration of action and infrequent side effects, is the preferred treatment of neurogenic diabetes insipidus in children and adults.