EFFICACY, SAFETY, AND DOSING OF DESMOPRESSIN FOR NOCTURNAL ENURESIS IN EUROPE

Desmopressin is a potent antidiuretic for nocturnal enuresis with few and mostly insignificant adverse reactions. Almost 80 years ago, the a ntidiuretic effects of extracts of the posterior pituitary were first reported. The molecular structure of the peptide vasopressin arginine vasopressin (AVP) became known in 1956, and by 1967, a synthesized mod ification of AVP, known as DDAVP, or desmopressin, was introduced. Tox icity studies performed on experimental animals support the conclusion that desmopressin is considerably more potent as an antidiuretic than AVP and has an exceptional safety margin. Further, clinical experienc e reveals that from 1974 to June 1992 only 21 patients using desmopres sin had serious adverse reactions (water intoxication), and no fatalit ies occurred. Seven of 10 children with nocturnal enuresis who receive desmopressin stop their bedwetting completely or reduce it significan tly, with best results noted in children over 10 years of age. Given t hese results, the preferred treatment in Europe for children with noct urnal enuresis is the sequential combination of desmopressin and the e nuresis alarm.