Treatment with new synthetic analogue of vasopressin in diabetes insipidus.

The aims of treatment of diabetes insipidus are replacement therapy with a vasopressin preparation, ancillary use of chlorpropamide or thiazide diuretics in some cases, and eradication of the underlying cause of the condition where appropriate. Replacement therapy only will be considered in this communication. This poses several problems. Pitressin snuff may cause local complications such as chronic rhinitis as well as pulmonary problems, for example bronchospasm and pulmonary fibrosis; lysine vasopressin nasal snuff has the disadvantage of a short duration of action. Injections of pitressin may result in physical pain and psychological upset, as exemplified in this case; also, preparation of the solution is crucial in order to prevent administration of the inert vehicle in the absence of the active pitressin. DDAVP (l-deamino-8-D-arginine vasopressin) has been claimed to possess a higher antidiuretic potency and a longer duration of action than the vasopressin preparations currently in use. Andersson and Arner (1972) reported success with DDAVP in the management of 10 adult patients with cranial diabetes insipidus of various aetiologies, but no similar experience has been reported in children.