Beer Potomania: A Systematic Review of Characteristics, Diagnosis and Treatment

Abstract

Beer potomania is a rare but potentially severe cause of hyponatremia due to excessive intake of low-solute alcoholic fluids, particularly beer. In this systematic review, we aimed to synthesize the current literature on this condition, focusing on pathophysiology, clinical presentation, diagnostic criteria, and management approaches. Following PRISMA 2020 guidelines, we searched PubMed, Embase, Scopus, and Web of Science for studies published up to December 2024. Five observational studies involving a total of 443 patients met the inclusion criteria, primarily involving alcohol-dependent individuals or those with psychiatric disorders. Common clinical features included altered mental status, seizures, and weakness; treatments typically comprised isotonic saline infusion, fluid restriction, and—less frequently—desmopressin or loop diuretics. The methodological quality of included studies was moderate with heterogeneous diagnostic thresholds. Our findings highlight that beer potomania remains under-recognized in clinical practice; prompt identification and tailored treatment—including cautious sodium (Na) correction and monitoring to prevent osmotic demyelination syndrome—is crucial. Further research is needed to establish standardized diagnostic criteria, evaluate the role of dietary sodium strategies, and develop evidence-based management protocols.