DESMOPRESSIN AND IMIPRAMINE IN THE MANAGEMENT OF NOCTURNAL ENURESIS -A MULTICENTER STUDY

The efficacy and safety of desmopressin (Minirin/DDAVP) treatment comp ared with imipramine were investigated in a multicentre, open, cross-o ver design in 57 patients, aged 6-15 years, affected by nocturnal enur esis to establish the best therapeutic approach to this condition. Aft er a two-week observation and control period, patients were randomised to one of two groups: intranasal administration of desmopressin, 30 m u g/day for three weeks, followed by imipramine, 0.9 mg/kg for a furth er three weeks, or imipramine 0.9 mg/kg for three weeks, followed by d esmopressin, 30 mu g/day for a further three weeks. Following treatmen t, all patients were observed for a further two weeks. Administration of either treatment protocol resulted in a statistically significant d ecline in the number of enuretic episodes per week compared to the con trol. The greater antidiuretic effect observed in the group receiving imipramine followed by desmopressin suggests the two compounds have di fferent profiles. Also, when the treatment period was compared with th e follow-up, the antidiuretic effect had a longer duration in the grou p initially given imipramine. No further improvement was seen when des mopressin was administered first, with a mild worsening of the effect sometimes occurring, suggesting a different carry-over effect between the two treatments. This suggests that desmopressin offers a better ap proach to the management of nocturnal enuresis.