title: An open, in-patient incremental safety and efficacy study of desmopressin in women with multiple sclerosis and nocturia.
abstract: OBJECTIVE
  To examine the safety and efficacy of desmopressin in three doses given to women with multiple sclerosis to treat nocturia with or without enuresis.
  
  
  METHODS
  Eight women with clinically confirmed multiple sclerosis and nocturia with or without enuresis were entered as in-patients into an open, nonrandomized, placebo-controlled study of incremental doses of 20, 40 and 60 micrograms desmopressin. Urinary and serum sodium, plasma arginine vasopressin and urine osmolality were monitored every 4 h for 24 h. A single dose of placebo or desmopressin was given during each of four 24-h periods.
  
  
  RESULTS
  There was a significant decrease in nocturnal urinary volumes and a significant increase in nocturnal urinary osmolalities in patients taking desmopressin when compared with those taking a placebo, but there was no difference among the desmopressin doses. There was no significant difference in serum sodium level between the desmopressin doses. However, at the end of the 24-h period with the 60 micrograms dose, serum sodium was decreased significantly.
  
  
  CONCLUSIONS
  Neither a significant decrease in nocturnal urinary volumes nor an increase in urinary osmolality was achieved by doses of desmopressin > 20 micrograms. A dose of 60 g was associated with a decreased serum sodium level at the end of the 24-h period but there was no biochemical hyponatraemia. Because there were no benefits and a possibility of clinical hyponatraemia with higher doses, doses of > 20 micrograms desmopressin cannot be recommended.
authors.affiliation: Bristol Urological Institute, Southmead Hospital, UK.
authors.forename: S D
authors.initials: SD
authors.lastname: Eckford
authors.forename: P G
authors.initials: PG
authors.lastname: Carter
authors.forename: S R
authors.initials: SR
authors.lastname: Jackson
authors.forename: M D
authors.initials: MD
authors.lastname: Penney
authors.forename: P
authors.initials: P
authors.lastname: Abrams
mesh_terms: D000328:Adult; D003894:Deamino Arginine Vasopressin / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D007010:Hyponatremia / Q000209:etiology; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications*; D009994:Osmolar Concentration; D012076:Renal Agents / Q000627:therapeutic use*; D012964:Sodium / Q000652:urine; D014554:Urination; D014555:Urination Disorders / Q000188:drug therapy* / Q000209:etiology
chemical_list: D012076:Renal Agents; D012964:Sodium; D003894:Deamino Arginine Vasopressin