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Clonidine may have a beneficial effect on refractory nocturnal enuresis
Author(s) -
Ohtomo Yoshiyuki
Publication year - 2017
Publication title -
pediatrics international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.49
H-Index - 63
eISSN - 1442-200X
pISSN - 1328-8067
DOI - 10.1111/ped.13269
Subject(s) - enuresis , medicine , clonidine , desmopressin , refractory (planetary science) , anesthesia , bedtime , imipramine , adverse effect , pediatrics , urology , physics , alternative medicine , pathology , astrobiology
Background Although the evidence‐based treatment for nocturnal enuresis is established, nearly one‐third of patients are still enuretic with desmopressin, anti‐cholinergic treatment and alarm. The fourth option, imipramine, is limited because of the risk of cardiotoxicity on overdose. Clonidine, an α 2 ‐adrenoceptor agonist that also has noradrenergic effects like imipramine, is a new option for refractory enuresis. Methods A total of 148 patients (6–14 years of age; mean, 9.1 years) with refractory enuresis under desmopressin, anti‐cholinergic treatment and alarm were enrolled. The patients consisted of 100 boys and 48 girls, of whom 23 had monosymptomatic nocturnal enuresis and 125 had non‐monosymptomatic nocturnal enuresis. Clonidine 4 μg/kg/day (maximum, 75 μg/day) orally 30 min before bedtime was added and its effects were evaluated after 4 weeks of treatment. Results A total of 83 patients (56.1%) achieved partial or complete response with the additional clonidine. No significant adverse reactions were noted. Conclusions Clonidine could be an aid for refractory enuresis, although further randomized controlled trials are needed.