A COMPARISON OF AMITRIPTYLINE, VASOPRESSIN AND AMITRIPTYLINE WITH VASOPRESSIN IN NOCTURNAL ENURESIS

Forty-five children aged 6-14 years with primary nocturnal enuresis we re randomised to determine whether desmopressin is more effective than amitriptyline and whether the combination of amitriptyline/desmopress in is more effective than amitriptyline or desmopressin alone. Amitrip tyline dosage was 25 mg for children 6-10 years and 50 mg for children aged 10-14 years. Desmopressin (20 mu g) was given in the same dosage for all age groups, After a run-in period of 2 weeks, children were t reated for 16 weeks and then observed for 12 weeks, In the amitriptyli ne group mean wet nights per week decreased from 5.8 +/- 0.9 to 3.3 +/ - 1.9 (P < 0.0005); in the desmopressin group mean wet nights per week decreased from 6.0 +/- 0.9 to 4.7 +/- 1.7 (P < 0.02); in the amitript yline/desmopressin group mean wet nights per week decreased from 6.3 /- 0.9 to 3.3 +/- 2.5 (P < 0.0006). When comparing the groups, amitrip tyline/desmopressin and amitriptyline were statistically more effectiv e than demopressin in week 6 (P < 0.009), week 8 (P < 0.03) and week 1 0 (P < 0.04). No significant side effects occurred. At this dose amitr iptyline was more effective than desmopressin and the combination of d esmopressin and amitriptyline did not confer any additional benefit.