Combination Therapy of Imipramine with Oxybutynin in Children with Enuresis Nocturna

Tahmaz, Lütfü; Kïbar, Yusuf; Yıldırım, İbrahim; Ceylan, Süleyman; Dayanç, Murat

doi:10.1159/000064858

Cited by 19 publications

(3 citation statements)

References 28 publications

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“…Our study like the previous ones used combined imipramine with anticholinergic (oxybutynin), reported that combined therapy was more effective in MNE. 19,20 We used a low dose (25 mg) of imipramine in order to avoid its potential side effects and to combine it with the synergistic anticholinergic action of solifenacin. We did not assess the nocturnal urine production to increase patient’s compliance.…”

Section: Discussionmentioning

confidence: 99%

Can the combined treatment of solifenacin and imipramine has a role in desmopressin refractory monosymptomatic nocturnal enuresis? A prospective double-blind randomized placebo-controlled study

2021

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Background: Nocturnal enuresis is a common disease of childhood. It can be classified into monosymptomatic nocturnal enuresis (MNE) or nonmonosymptomatic nocturnal enuresis (NMNE). Imipramine is a tricyclic antidepressant used to treat enuresis with initial success rates are high as 50% but some studies record a high relapse rate and it has a cardiotoxic effect when overdosed. Anticholinergics may be effective in the treatment of children with bladder storage dysfunction, including daytime incontinence. However, anticholinergics monotherapy is not effective in treating MNE. In our study, we used a low dose (25 mg) of imipramine in order to avoid its potential side effects and combined it with the synergistic anticholinergic action of solifenacin. Our objective was to evaluate the efficacy and safety of the combination of solifenacin and imipramine compared with placebo in the treatment of desmopressin refractory MNE. Methods: One hundred children aged 6 years or more with primary MNE unresponsive to desmopressin treatment were included. The children were randomly divided into two equal groups. Group A received imipramine 25 mg and solifenacin 5–10 mg oral tablets and group B received placebo once 1 h before bedtime for 3 months. The primary end point was to investigate the efficacy of the combined treatment of solifenacin and imipramine and the secondary end point was the safety of the drugs. Results: Our study showed that the mean post treatment wet nights per month was significantly lesser in the treatment group than placebo group ( p < 0.001) and cure rate was significantly higher in treatment group than placebo group ( p < 0.001). The relapse rate was statistically significantly lower in treatment group than placebo group ( p = 0.032). No significant side effects related to the drugs were reported. Conclusion: The combination treatment of solifenacin and imipramine is a useful and safe treatment for nocturnal enuresis after failure of everything else.

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Section: Discussionmentioning

confidence: 99%

Can the combined treatment of solifenacin and imipramine has a role in desmopressin refractory monosymptomatic nocturnal enuresis? A prospective double-blind randomized placebo-controlled study

2021

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“…Combination therapy including imipramine and anticholinergics showed improved results when compared to imipramine alone or placebo in the short and long term, with fewer relapses than imipramine monotherapy (54, 58). The combination of tricyclic antidepressants and desmopressin did not show any improvement in treatment results (54, 59).…”

Section: Other Drugsmentioning

confidence: 97%

Brazilian consensus in enuresis–recomendations for clinical practice

et al. 2019

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Introduction Enuresis, defined as an intermittent urinary incontinence that occurs during sleep, is a frequent condition, occurring in about 10% of children at 7 years of age. However, it is frequently neglected by the family and by the primary care provider, leaving many of those children without treatment. Despite of many studies in Enuresis and recent advances in scientific and technological knowledge there is still considerable heterogeneity in evaluation methods and therapeutic approaches. Materials and Methods The board of Pediatric Urology of the Brazilian Society of Urology joined a group of experts and reviewed all important issues on Enuresis and elaborated a draft of the document. On September 2018 the panel met to review, discuss and write a consensus document. Results and Discussion Enuresis is a multifactorial disease that can lead to a diversity of problems for the child and family. Children presenting with Enuresis require careful evaluation and treatment to avoid future psychological and behavioral problems. The panel addressed recommendations on up to date choice of diagnosis evaluation and therapies.

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“…To our knowledge, there is only one report of a combined therapy using a tricyclic antidepressant with an anticholinergic agent which has been published recently [8]. This is surprising since each drug type appears to have a different effect on urinary bladder function.…”

Section: Introductionmentioning

confidence: 99%

Combined pharmacotherapy for nocturnal enuresis

Kaneko¹,

Fujinaga²,

Ohtomo³

et al. 2001

Pediatric Nephrology

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Nocturnal enuresis is a common childhood disorder. Tricyclic antidepressants and anticholinergic agents have been the well accepted pharmacological treatment for this disorder and are efficacious in 40-70% and 10-50% of cases, respectively. The present study was performed to evaluate the effect of a combined treatment of tricyclic antidepressant and an anticholinergic agent. Twenty-two children aged 6-12 years with primary monosymptomatic nocturnal enuresis who did not prefer to use a conditioning alarm were given a combined treatment of these drugs. After a control period of 1 month, each patient was treated for 6 months and then observed for 3 months. A 30-mg dose of amitriptyline or imipramine was given with either 2-4 mg oxybutinin or 10-20 mg propiverine. Efficacy was determined relative to the number of wet nights per week compared with the control period, with more than a 50% decrease in wet nights per week taken to indicate efficacy. The mean wet nights per week decreased from 6.1 to 1.7 (P<0.01), and efficacy was established in 20 patients (90.9%). Relapses occurred in 60.0% of patients during the follow-up period. No significant side effects were observed. The efficacy of the combined therapy in monosymptomatic nocturnal enuresis appears to be greater than that reported for either drug alone, and therefore can be a choice of treatment in order to motivate children with nocturnal enuresis.

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Combination Therapy of Imipramine with Oxybutynin in Children with Enuresis Nocturna

Cited by 19 publications

References 28 publications

Can the combined treatment of solifenacin and imipramine has a role in desmopressin refractory monosymptomatic nocturnal enuresis? A prospective double-blind randomized placebo-controlled study

Can the combined treatment of solifenacin and imipramine has a role in desmopressin refractory monosymptomatic nocturnal enuresis? A prospective double-blind randomized placebo-controlled study

Brazilian consensus in enuresis–recomendations for clinical practice

Combined pharmacotherapy for nocturnal enuresis

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