No, Taking an SSRI Does Not Cause Diabetes Insipidus
Diabetes insipidus is not a recognized or expected adverse effect of SSRI therapy at therapeutic doses. 1
Understanding the Distinction
You do not have diabetes insipidus from taking an SSRI. The National Institute of Diabetes and Digestive and Kidney Diseases explicitly states that diabetes insipidus should not be considered a typical or expected adverse effect of SSRI therapy, with high-strength evidence supporting this conclusion. 1
What SSRIs Actually Cause
SSRIs have well-documented side effects, but diabetes insipidus is not among them:
Common SSRI side effects include sweating, diarrhea, dizziness, dry mouth, fatigue, headache, sexual dysfunction, tremor, and weight gain, with 10-20% of patients discontinuing treatment due to these effects. 1
Gastrointestinal disturbances are particularly common with SSRIs, including altered bowel habits and abdominal discomfort. 1
What Actually Causes Diabetes Insipidus
Diabetes insipidus results from either inadequate ADH production (central DI) or renal insensitivity to ADH (nephrogenic DI). 2, 3
Drug-induced nephrogenic diabetes insipidus has specific culprits:
Lithium is by far the most common medication cause, accounting for 159 of 359 reports in the WHO adverse effect database and affecting approximately 10% of patients on long-term lithium therapy. 4
Other documented causes include foscarnet (15 reports) and clozapine (10 reports), typically occurring in critically ill patients receiving multiple antimicrobials and cytostatics. 4
SSRIs are not listed among the medications that cause drug-induced diabetes insipidus. 4
When to Actually Suspect Diabetes Insipidus
True diabetes insipidus presents with:
Polyuria (excessive urine output, often >4 liters/day) and polydipsia (excessive thirst, particularly craving cold water). 2, 5
Marked decreases in urine specific gravity and osmolality. 2
If you're experiencing these symptoms while on an SSRI, the SSRI is not the cause—you need evaluation for central causes (pituitary pathology, trauma, surgery) or nephrogenic causes (other medications, genetic factors, kidney disease). 7, 2
Important Clinical Caveat
The diagnosis of diabetes insipidus requires formal testing with a water deprivation test followed by desmopressin administration, which is the gold standard for distinguishing between central and nephrogenic DI and differentiating it from primary polydipsia. 2, 6