title: Clonidine may have a beneficial effect on refractory nocturnal enuresis.
abstract: BACKGROUND
  Although the evidence-based treatment for nocturnal enuresis is established, nearly one-third of patients are still enuretic with desmopressin, anti-cholinergic treatment and alarm. The fourth option, imipramine, is limited because of the risk of cardiotoxicity on overdose. Clonidine, an α2-adrenoceptor agonist that also has noradrenergic effects like imipramine, is a new option for refractory enuresis.
  
  
  METHODS
  A total of 148 patients (6-14 years of age; mean, 9.1 years) with refractory enuresis under desmopressin, anti-cholinergic treatment and alarm were enrolled. The patients consisted of 100 boys and 48 girls, of whom 23 had monosymptomatic nocturnal enuresis and 125 had non-monosymptomatic nocturnal enuresis. Clonidine 4 μg/kg/day (maximum, 75 μg/day) orally 30 min before bedtime was added and its effects were evaluated after 4 weeks of treatment.
  
  
  RESULTS
  A total of 83 patients (56.1%) achieved partial or complete response with the additional clonidine. No significant adverse reactions were noted.
  
  
  CONCLUSIONS
  Clonidine could be an aid for refractory enuresis, although further randomized controlled trials are needed.
authors.affiliation: Department of Pediatrics, Juntendo University Nerima Hospital, Nerima, Tokyo, Japan.
authors.forename: Yoshiyuki
authors.identifier: http://orcid.org/0000-0002-5436-143X
authors.initials: Y
authors.lastname: Ohtomo
mesh_terms: D000284:Administration, Oral; D000293:Adolescent; D058647:Adrenergic alpha-2 Receptor Agonists / Q000627:therapeutic use*; D002648:Child; D003000:Clonidine / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008297:Male; D053206:Nocturnal Enuresis / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D058647:Adrenergic alpha-2 Receptor Agonists; D003000:Clonidine
keywords: clonidine; desmopressin; nocturnal enuresis