A 35 year-old man with bipolar disorder, maintained on lithium for 10 years, is referred to you for chronic polyuria. He complains he has to void every hour.

• A 35 year-old man with bipolar disorder, maintained on lithium for 10 years, is referred to you for chronic polyuria. He complains he has to void every hour.

• Labs:

• Na 146 BUN/creatinine 35/1.9

• Serum osmolality 305 mOsm/kg

• 24 hour urine volume 5 liters

• Urine osmolality 190 mOsm/kg

• Which of the following would be appropriate in this patient?

• Thiazide diuretic

• Demeclizine

• Vassopressin receptor V2 antagonist

• Fluid restriction

• Furosemide