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08:12 - 08:18
ICCS S3-3
(LO)
REBOXETINE IN THERAPY-RESISTANT ENURESIS
Elisabet LUNDMARK and Tryggve NEVÉUS
Uppsala University Children Hospital, Pediatric Nephrology, Uppsala, SWEDEN
PURPOSE
The aim of this study was to determine whether there is a role for the noradrenergic antidepressant reboxetine, as
monotherapy or combined with desmopressin, in the treatment of therapy-resistant enuresis, and whether there are
side effects involved. We also sought prognostic factors in anamnestic data and in the voiding chart.
MATERIAL AND METHODS
This was a randomized placebo-controlled study with a double-blind cross-over design. After baseline documentation of
enuresis during 14 days and the completion of a voiding chart including measurements of nocturnal urine production, all
children underwent treatment during three four-weeks periods: one with reboxetine 4mg and placebo, one with
reboxetine 4mg and desmopressin 240 ug, and one with double placebo treatment. The reduction of wet nights between
baseline and the last two weeks of each treatment period were compared.
RESULTS
Eighteen children were included. When the reduction of wet nights with treatment with reboxetine in monotherapy and
in combination therapy with desmopressin respectively was compared to that of placebo treatment, using the
nonparametric Wilcoxon signed ranks test, a highly significant (p=0.004 resp 0.002) difference was found.
With reboxetine in monotherapy six children experienced negative side effects, as compared to three with combination
therapy, and two with placebo. All of these side effects were reversible, and most were mild. One patient chose to cease
treatment because of side effects (headache)
No prognostic factors was found in either the anmnestic data or in the voiding chart.
CONCLUSIONS
Reboxetine seems to be an alternative in the treatment of enuretic children who have not responded to standard
treatment.