AN OPEN, INPATIENT INCREMENTAL SAFETY AND EFFICACY STUDY OF DESMOPRESSIN IN WOMEN WITH MULTIPLE-SCLEROSIS AND NOCTURIA

Objectives To examine the safety and efficacy of desmopressin in three doses given to women with multiple sclerosis to treat nocturia with o r without enuresis. Patients and methods Eight women with clinically c onfirmed multiple sclerosis and nocturia with or without enuresis were entered as in-patients into an open, non-randomized, placebo-controll ed study of incremental doses of 20, 40 and 60 mu g desmopressin, Urin ary and serum sodium, plasma arginine vasopressin and urine osmolality were monitored every 4 h for 24 h, A single dose of placebo or desmop ressin was given during each of four 24-h periods. Results There was a significant decrease in nocturnal urinary volumes and a significant i ncrease in nocturnal urinary osmolalities in patients taking desmopres sin when compared with those taking a placebo, but there was no differ ence among the desmopressin doses, There was no significant difference in serum sodium level between the desmopressin doses. However, at the end of the 24-h period with the 60 mu g dose, serum sodium was decrea sed significantly. Conclusions Neither a significant decrease in noctu rnal urinary volumes nor an increase in urinary osmolality was achieve d by doses of desmopressin >20 mu g. A dose of 60 g was associated wit h a decreased serum sodium level at the end of the 24-h period but the re was no biochemical hyponatraemia, Because there were no benefits an d a possibility of clinical hyponatraemia with higher doses, doses of >20 mu g desmopressin cannot be recommended.