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The system exerts its influence via release or inhibition of vasopressin (antidiuretic hormone, ADH) which acts on the kidney to decrease water excretion. Deficiency of ADH is usually due to hypothalamic-neurohypophyseal lesions (central diabetes insipidus) or insensitivity of the kidney to ADH (nephrogenic diabetes insipidus). These patients, if untreated, have the predictable result of dehydration, hyperosmolality, hypovolemia, and eventual death in severe cases.
Antidepressant and antipsychotic drugs cause hyponatremia through the development of SIADH. Antiepileptic drugs: Carbamezepine, oxcarbazepine, sodium valproate, lamotrigine. Carbamazepine, oxcarbazepine and sodium valproate cause an increase in production of ADH, whereas carbamazepine and lamotrigine cause potentiation of ADH effect.