Nortriptyline for treating enuresis in ADHD—a randomized double-blind controlled clinical trial

Ghanizadeh, Ahmad; Haghighat, Rezvan

doi:10.1007/s00467-012-2211-z

Cited by 6 publications

(1 citation statement)

References 18 publications

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“…In this study, 10 (22.7%) of the test subjects and 17 (39.5%) of the placebo subjects were found to have ADHD [ 31 ]. Ghanizadeh [ 42 ] conducted an RCT with 43 children with comorbid ADHD and nocturnal enuresis, and found that treatment with methylphenidate and nortriptyline was superior to methylphenidate and placebo in reducing nocturnal enuresis events, but there was notable relapse of symptoms once treatment was withdrawn. Increased sphincter tone may have led to the reported urinary retention in one case of an 8-year-old child treated with atomoxetine with ADHD [ 43 ].…”

Section: Resultsmentioning

confidence: 99%

Optimising the management of children with concomitant bladder dysfunction and behavioural disorders

Eliezer

Lam

Smith

et al. 2022

Eur Child Adolesc Psychiatry

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Bladder dysfunction and behavioural disorders in children are commonly concomitant; hence, it is difficult to treat each in isolation. Pharmacotherapy is common treatment for behavioural disorders, and these medications may have intended or unintended positive or negative bladder sequelae. This review identifies the literature regarding the effects of behavioural pharmacotherapy on bladder functioning and possible bladder management strategies in children with concomitant behaviour and bladder disorders to enable clinicians to better manage both conditions. A PROSPERO registered PRISMA-guided review of three major databases was performed. After an initial scoping study revealed significant heterogeneity, a narrative approach was undertaken to discuss the results of all relevant cases relating to children being treated with pharmacotherapy for behaviour disorders and outcomes related to bladder function. Studies were screened to identify those that described effects of commonly prescribed medications in children with behavioural disorders such as stimulants, alpha 2 agonists, tricyclic antidepressants (TCA), serotonin and noradrenergic reuptake inhibitors (SNRI), selective serotonin reuptake inhibitors (SSRI) and antipsychotics, and the findings and implications were summarised. The review identified 46 studies relevant to behavioural pharmacotherapy and bladder function (stimulants (n = 9), alpha 2 agonists (n = 2), TCAs (n = 7), SNRIs (n = 8), SSRIs (n = 8) and antipsychotics (n = 6). Six studies focused specifically on bladder management in children with behavioural disorders with concurrent behavioural pharmacotherapy. This review identifies useful factors that may assist clinicians with predicting unintended bladder effects following initiation of behavioural pharmacotherapy to facilitate the best approach to the treatment of bladder dysfunction in children with behavioural disorders. With this evidence, we have provided a useful decision-making algorithm to aide clinicians in the management of these dual pathologies.

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Section: Resultsmentioning

confidence: 99%

Optimising the management of children with concomitant bladder dysfunction and behavioural disorders

Eliezer

Lam

Smith

et al. 2022

Eur Child Adolesc Psychiatry

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Alarm interventions for nocturnal enuresis in children

Codarini

Stewart

Hahn

et al. 2020

Cochrane Database of Systematic Reviews

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Methylphenidate for attention deficit hyperactivity disorder (ADHD) in children and adolescents - assessment of adverse events in non-randomised studies

Storebø

Pedersen

Ramstad

et al. 2018

Cochrane Database of Systematic Reviews

244

161

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Our findings suggest that methylphenidate may be associated with a number of serious adverse events as well as a large number of non-serious adverse events in children and adolescents, which often lead to withdrawal of methylphenidate. Our certainty in the evidence is very low, and accordingly, it is not possible to accurately estimate the actual risk of adverse events. It might be higher than reported here.Given the possible association between methylphenidate and the adverse events identified, it may be important to identify people who are most susceptible to adverse events. To do this we must undertake large-scale, high-quality RCTs, along with studies aimed at identifying responders and non-responders.

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Nortriptyline for treating enuresis in ADHD—a randomized double-blind controlled clinical trial

Abstract: Administration of nortriptyline for treating enuresis in ADHD has not been investigated before. Nortriptyline is statistically superior to placebo. However, enuresis will relapse after stopping nortriptyline in children with ADHD who continue taking methylphenidate.

Cited by 6 publications

References 18 publications

Optimising the management of children with concomitant bladder dysfunction and behavioural disorders

Optimising the management of children with concomitant bladder dysfunction and behavioural disorders

Alarm interventions for nocturnal enuresis in children

Methylphenidate for attention deficit hyperactivity disorder (ADHD) in children and adolescents - assessment of adverse events in non-randomised studies

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