Question:
Drug of choice for central diabetes insipidus is?
Drug of choice for central diabetes insipidus is?
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Replace the missing hormone: a long-acting V2-selective vasopressin analogue.
Updated On: Jun 24, 2026
- Desmopressin
- Leuprolide
- Thiazide diuretics
- Insulin
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The Correct Option is A
Solution and Explanation
Step 1: Central (neurogenic) diabetes insipidus is caused by deficient secretion of antidiuretic hormone (ADH, vasopressin) from the posterior pituitary, leading to the kidney's inability to concentrate urine.
Step 2: The logical treatment is to replace the missing hormone. Desmopressin (DDAVP) is a synthetic analogue of vasopressin that selectively stimulates V2 receptors in the renal collecting ducts, promoting water reabsorption.
Step 3: Compared with native vasopressin, desmopressin has a longer duration of action and minimal V1 (vasopressor) activity, so it controls polyuria without significant pressor effects. It is the drug of choice for central DI.
Step 4: The other options are wrong: Leuprolide is a GnRH analogue used in prostate cancer and endometriosis. Thiazide diuretics are used in NEPHROGENIC DI (paradoxical antidiuretic effect), not central DI. Insulin treats diabetes mellitus, an unrelated disease.
Conclusion: The correct answer is Desmopressin, matching the printed key.
Step 2: The logical treatment is to replace the missing hormone. Desmopressin (DDAVP) is a synthetic analogue of vasopressin that selectively stimulates V2 receptors in the renal collecting ducts, promoting water reabsorption.
Step 3: Compared with native vasopressin, desmopressin has a longer duration of action and minimal V1 (vasopressor) activity, so it controls polyuria without significant pressor effects. It is the drug of choice for central DI.
Step 4: The other options are wrong: Leuprolide is a GnRH analogue used in prostate cancer and endometriosis. Thiazide diuretics are used in NEPHROGENIC DI (paradoxical antidiuretic effect), not central DI. Insulin treats diabetes mellitus, an unrelated disease.
Conclusion: The correct answer is Desmopressin, matching the printed key.
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