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08:32 - 08:36
ICCS S3-7
(SO)
NOCTURNAL ENURESIS WITH ADHD: EXPERIENCE OF TREATMENT WITH
ATOMOXETINE
Yoshiyuki OHTOMO
Juntendo University Nerima Hospital, Pediatrics, Tokyo, JAPAN
PURPOSE
Recent studies showed that incontinence and ADHD co-exist and interact each other. However, the treatment for the
patients with nocturnal enuresis (NE) and ADHD has not been established.
We performed the treatment of NE with mild ADHD using atmoxetine.
MATERIAL AND METHODS
We treated 265 new patients with NE at Juntendo University Nerima Hospital & Musashi-murayama Hospital (Tokyo,
Japan) since May 2013 to October 2014, with ages of 6 – 14 (198 cases with MNE and 67 cases with NMNE). With the
routine interviews and physical examinations at the patients’ first visits, we had excluded the possibility of comorbid
ADHD and its related disorders. Patients with MNE were treated with or desmopressin and/or alarm and those with
NMNE were treated with anti-cholinergics and/or alarm. At 12-weeks after the treatments, 52 with MNE and 13 with
NMNE were classified as PR or NR. These 65 patients were re-assessed whether they had “subclinical” ADHD, and 24
patients (15 with MNE and 9 with NMNE) met the diagnostic criteria of DSM-IV-TR. They were treated with atomoxetine
(ATX) (1.8mg/kg/day) in addition to ongoing therapy for enuresis.
RESULTS
After 8-weeks ATX therapy, the average wet nights per months were significantly decreased: 17.1 to 2.7 in MNE
(P=0.0007) and 23.2 to 11.4 in NMNE (p=0.0117). Overall, ATX treatment was beneficial in 20 of 24 cases (FR:3, R:9,
PR:8, NR:4).
CONCLUSIONS
We need pay more attentions for the possible comorbid ADHD in refractory cases with NE, and recommend ATX therapy
for those patients.