title: Gabapentin: a novel drug as add-on therapy in cases of refractory overactive bladder in children.
abstract: OBJECTIVE
  To determine the effectiveness of gabapentin as an add-on therapy in children presenting with overactive bladder (OAB) not responding to conventional anticholinergics.
  
  
  METHODS
  Children with refractory OAB were included prospectively from March 2009 to February 2010. The inclusion criterion was persistence of symptoms while on conventional anticholinergics for 6 months. Gabapentin was prescribed as an add-on therapy. The patients were followed 4 weekly with bladder diary and urodynamic study was repeated at 3 months.
  
  
  RESULTS
  There were 31 children, 26 of neurogenic OAB and 5 of non-neurogenic origin. Mean ± SD age was 8.5 ± 5.3 years. Data were analyzed in 30 patients as treatment was terminated in 1 due to adverse effects. Continence improved in 16 (53.3%) patients. Voiding volume improved from 175 ± 90 to 320 ± 110 ml (p<0.03). Objective assessment of OAB symptom relief showed marked improvement (p<0.05). Mean maximum cystometric bladder capacity improved from 210 ± 94 to 360 ± 110 ml (p<0.02). The maximal detrusor contraction decreased from 75 ± 35 to 25 ± 15 cmH(2)O (p<0.02). Fourteen patients (46.7%) failed to respond to gabapentin therapy. These patients had baseline maximum cystometric bladder capacity <60% for age and maximum detrusor contractions >50 cm of water (p<0.03).
  
  
  CONCLUSIONS
  Gabapentin gives moderate results in children with OAB refractory to conventional anticholinergics. In general, the drug is well tolerated with fewer adverse effects.
authors: Department of Urology and Renal Transplantation, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Raebareli Road, Lucknow 226014, U.P., India. ansarimsa@hotmail.com
authors: M S
authors: MS
authors: Ansari
authors: Aruna
authors: A
authors: Bharti
authors: Raj
authors: R
authors: Kumar
authors: Priyadarshi
authors: P
authors: Ranjan
authors: Aneesh
authors: A
authors: Srivastava
authors: Rakesh
authors: R
authors: Kapoor
mesh_terms: D000293:Adolescent; D000588:Amines / Q000008:administration & dosage* / Q000009:adverse effects; D000927:Anticonvulsants / Q000008:administration & dosage / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D018680:Cholinergic Antagonists / Q000008:administration & dosage* / Q000009:adverse effects; D003509:Cyclohexanecarboxylic Acids / Q000008:administration & dosage* / Q000009:adverse effects; D004351:Drug Resistance; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D000077206:Gabapentin; D006801:Humans; D008297:Male; D011446:Prospective Studies; D016896:Treatment Outcome; D001743:Urinary Bladder / Q000187:drug effects / Q000294:innervation; D053201:Urinary Bladder, Overactive / Q000188:drug therapy*; D014563:Urodynamics / Q000187:drug effects*; D005680:gamma-Aminobutyric Acid / Q000008:administration & dosage* / Q000009:adverse effects
chemical_list: D000588:Amines; D000927:Anticonvulsants; D018680:Cholinergic Antagonists; D003509:Cyclohexanecarboxylic Acids; D005680:gamma-Aminobutyric Acid; D000077206:Gabapentin