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Mode of action and relative value of imipramine and similar drugs in the treatment of nocturnal enuresis

  • K. E. Petersen
  • O. O. Andersen
  • T. Hansen
Originals

Summary

The present study was partly a clinical pharmacological analysis of the action of imipramine in nocturnal enuresis and partly an attempt to select children who would benefit most from this treatment. 61 fairly severe cases of nocturnal enuresis were studied as out-patients, divided by the criteria primary/secondary enuresis and with/without associated behavioural disturbances. The patients received imipramine, imipramine-N-oxide, emepronium, and a placebo in random sequence in a double-blind cross-over trial. There was no difference in effect between placebo and emepronium; after imipramine the frequency of enuresis fell to 58% of the figure during placebo treatment, i.e. 31% of the children became dry; imipramine-N-oxide reduced the number of wet nights only to 78% of the number on placebo, 18% of the children became dry. When the patients were classified into groups imipramine and imipramine-N-oxide were found to have had the greatest effect in cases of presumed psychogenic aetiology, a 65% reduction of the frequency of wet nights whilst taking the placebo. The most favourable results were in children with combined nocturnal and diurnal enuresis and in those with urinary frequency and imperative urgency. The effect was maintained during treatment for 3 months with the most suitable drug. The dose was 50 mg regardless of the body weight of the patient. There were no serious side effects. It was concluded that the psychopharmacological actions of imipramine and imipramine-N-oxide appear to be important in their effects on enuresis. Imipramine might have been the best drug because success may require the combination of antidepressant and anticholinergic activity. It was not possible to assess in detail its presumed effect on the level of sleep. Thus many children can be treated successfully and the final cure of enuresis may be hastened by breaking a vicious circle of psychological phenomena.

Key words

Imipramine imipramine-N-oxide emepronium enuresis 

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Copyright information

© Springer-Verlag 1974

Authors and Affiliations

  • K. E. Petersen
    • 1
  • O. O. Andersen
    • 1
  • T. Hansen
    • 1
  1. 1.Children's Hospital, Fuglebakken and the Biological LaboratoriesDumex Ltd.CopenhagenDenmark

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