The Comparison of Therapeutic Effect between Imipramine and Desmopressin on Enuretic Patients

Ye, Jung Woo; Lee, Sang Don

Abstract

PURPOSE: Nocturnal enuresis is one of the most common disorders of childhood, occurring in 15% of 5 year-old children. Although usually self-limiting, justification for early treatment has been founded in psyc hological impact on the child. Many investigators have reported upon the effectiveness of prospectively studied to compare the therapeutic effect between imipramine (Tofranil) and desmopressin (Minirin/1-Desamino-8-D-Arginine Vasopressin: DDAVP) on the monosymptomatic enuretic patients.
MATERIALS AND METHODS
83 enuretic patients (primary enuresis 64 cases, secondary enuresis 19 cases) were randomized th one of two groups: imipramine group(44 cases) or desmopressin group (39 cases). They were free of other abnormalities in the screening tests. In addition to drug therapy, all of cases were performed motivational counselling, reduction of fluid in take prior to bedtime and voiding diary. The efficacy of drug was measured in reduction of the number of wet nights per week. During the treatment period, 83 cases were classified as excellent (0 to 1 wet night per week), good (over 59% reduction of wet night)and failed responder(less than 50% reduction of wet night).
RESULTS
Average age of imipramine group and desmopressin group was 9.3 years (range 5-17) and 9.6 years (range 5-17), respectively. The number of wet nights per week decreased respectively from a mean of 6.1 to 3.4 in imipramine group are from a mean of 6.4 to 2.3 in desmopressin group. Average therapeutic duration and overall response rate in the imipeamine group and desmopressin group was 9.1 weeks, 6.7 weeks (p<0.05) and 90.9%, 95.9%, respectively (p<0.05). The overall relapse rate of imipramine group and desmopressin group was 40.0% and 40.8% during the follow-up period of 3 months after cessation of medication in excellent responders. There was no difference in the therapeutic effects between primary and secondary enuresis on each drug therapy. There was also on no difference in the therapeutic response according to constipation. No serious side effects were observed in both groups.
CONCLUSIONS
These data suggest that the overall effects of imipramine and desmopressin are excellent. But desmopressin has more effective therapeutic response and more shorter therapeutic duration as compared with imipramine.