Hypernatremia is a common emergency room presentation and carries high mortality. We describe a case of a 56-year-old male patient with who presents with refusal to drink water for several weeks leading to the admission. He was diagnosed with psychogenic adipsia and was treated successfully with fluids, mirtazapine and clonazepam.
Keywords: adipsia; altered mental status; hypernatremia; infection; osmolality; osmotic demyelination; paranoia; stroke.