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Neurogenic Diabetes Insipidus: Management with dDAVP (1-Desamino-8-D Arginine Vasopressin)
Abstract
We used dDAVP, the 1-desamino-8-D arginine analogue of arginine vasopressin with high antidiuretic and low vasopressor potency, to treat 29 patients with neurogenic diabetes insipidus for up to 22 months. Intranasal dDAVP, 2.5 to 15 µg 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 µg of dDAVP every 14 to 18 h. Compared to previous therapy, side effects of dDAVP were minimal (headaches in two 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. We conclude that 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.
Article and Author Information
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▸From the Division of Endocrinology, New England Medical Center Hospital, and the Department of Medicine, Tufts University School of Medicine; Boston, Massachusetts.
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Grant support: studies were conducted on the Clinical Study Unit, New England Medical Center Hospital, and supported by U.S. Public Health Service Grants No. 2M01 RR00054 and No. AM 16684 and Training Grant AM 07039.
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▸Requests for reprints should be addressed to William E. Cobb, M.D.; Endocrinology Division, New England Medical Center Hospital, 171 Harrison Ave., Box 268; Boston, MA 02111.
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- Received July 23, 1977.
- Accepted November 10, 1977.
- © 1978 American College of Physicians
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