Reboxetine in therapy-resistant enuresis: a retrospective evaluation.
OBJECTIVE
Imipramine is the only evidence-based treatment available for enuretic children resistant to standard therapy. The drug's antienuretic effect is probably due to noradrenergic facilitation. The drug is, however, potentially cardiotoxic. In this study, the non-cardiotoxic noradrenergic antidepressant reboxetine was tested as an alternative to imipramine.


METHODS
61 patients, aged 7-19 years, with enuresis-resistant to desmopressin, the alarm, urotherapy and anticholinergics, were given 4-8 mg reboxetine at bedtime, if necessary combined with desmopressin.


RESULTS
32 patients became dry on reboxetine treatment, although 21 of them required combination treatment with desmopressin to achieve this. Eighteen children did not respond and eight children discontinued because of side-effects before treatment could be evaluated. No serious adverse events occurred.


CONCLUSIONS
These results need to be confirmed with randomized controlled studies, but indicate that reboxetine will become a safe and efficient treatment alternative for enuretic children resistant to standard therapy.
Lundmark
Elisabet
E
Uppsala University Children's Hospital, Uppsala, Sweden. elisabet.lundmark@lul.se
Nevéus
Tryggve
T
D000284:Administration, Oral; D000293:Adolescent; D018759:Adrenergic Uptake Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D050034:Antidiuretic Agents / Q000627:therapeutic use; D002648:Child; D003894:Deamino Arginine Vasopressin / Q000627:therapeutic use; D004305:Dose-Response Relationship, Drug; D004351:Drug Resistance; D004775:Enuresis / Q000188:drug therapy* / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007099:Imipramine / Q000627:therapeutic use; D008297:Male; D009025:Morpholines / Q000008:administration & dosage / Q000627:therapeutic use*; D010865:Pilot Projects; D011379:Prognosis; D000077593:Reboxetine; D012189:Retrospective Studies; D014554:Urination / Q000187:drug effects; D055815:Young Adult
D018759:Adrenergic Uptake Inhibitors; D050034:Antidiuretic Agents; D009025:Morpholines; D000077593:Reboxetine; D003894:Deamino Arginine Vasopressin; D007099:Imipramine