Psychogenic polydipsia is a psychiatric condition characterized by excessive drinking of water. In studies conducted regarding psychogenic or primary polydipsia, it’s been reported in patients with psychiatric disorders. Excessive drinking of water can lead to excessive fluid loading and electrolyte imbalance. We aimed to present a patient case with psychotic disorder who developed hyponatremia due to extreme water drinking and applied to emergency service with loss of consciousness. Case Presentation: Thirty-four-year-old male, secondary school graduate, single, living with his family was applied to emergency room clinically unconscious. In physical examination, general situation was bad, glasgow coma scale score point was 8. Minimal brain edema was detected in cranial computed tomography (CT). In laboratory tests Na: 109 mmol / L (136-145 mmol / L). The patient who was diagnosed with schizophrenia used drugs he could not remember its name. For the past 3 years, the patient has been using amylsulpride 1200 mg / day, valproic acid + sodium valproate 1000 mg / day and clozapine 600 mg / day. The patient was treated in emergency room with 150 ml 3% hypertonic infusion twice in 20 minutes to increase the Na concentration in the first hour by 5 mmol / L and to relieve symptoms. As conclusion, hyponatremia patients may apply to emergency room with nonspecific symptoms such as nausea and vomiting at the onset and consciousness changes that may progress to coma. Psychogenic polydipsia-associated hyponatremia should be considered in patients with similar clinical findings and psychiatric history admitted to emergency room.

Repetitive transcranial magnetic stimulation is an effective treatment option for treatment resistant depressive disorder. The presented case suggests that repetitive transcranial magnetic stimulation might be effective in inhibition of binge eating and purging behaviors. This case suggests that left dorsolateral prefrontal stimulation with high frequency repetitive transcranial magnetic stimulation could be a potential treatment option for bulimia nervosa comorbid with depressive disorder

Controversies emerged in linking middle cranial fossa-arachnoid cyst to psychosis. Despite the anatomical association between such cyst and psychosocial behaviour, still several features of the cyst itself hamper causation. I report a case of a young female labeled refractory schizophrenia who presented with antipsychotic toxicity overlooking an arachnoid cyst in the middle cranial fossa. Due to the paucity of information in the literature on such association here I discuss further implications from a first medical encounter, from a patient’s perspective and from a disposition perspective as well.