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Nortriptyline for treating enuresis in ADHD—a randomized double-blind controlled clinical trial

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Abstract

Background

Treating enuresis in children with attention deficit hyperactivity disorder (ADHD) has not been previously reported. This study aims to investigate the efficacy, tolerability, and adverse effects of nortriptyline for treating enuresis in children with ADHD.

Methods

Forty-three children aged from 5 to 14 years old were randomized into two groups. The treatment group received methylphenidate plus nortriptyline, while the placebo group received methylphenidate plus placebo. Nortriptyline and placebo were administered for 30 days and methylphenidate was administered for 45 days. The major outcome measure was parent-reported frequency of enuresis for 2 weeks prior to the intervention, during the intervention, and for 2 weeks after stopping the adjuvant therapy. Adverse effects were also checked.

Results

While nortriptyline statistically decreased the incidence of nocturnal enuresis during the intervention, the number of enuresis events did not significantly change in the placebo group. In addition, enuresis was not different from the baseline frequency of enuresis after stopping nortriptyline or placebo administration. Both nortriptyline and placebo were tolerated well.

Conclusions

Administration of nortriptyline for treating enuresis in ADHD has not been investigated before. Nortriptyline is statistically superior to placebo. However, enuresis will relapse after stopping nortriptyline in children with ADHD who continue taking methylphenidate.

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Acknowledgments

This study was Dr. R. Haghighat’s undergraduate thesis and was supported by a grant (90-01-34-2712) under the supervision Dr. Ahmad Ghanizadeh. The Research Improvement Center of Shiraz University of Medical Sciences and Ms. A. Keivanshekouh are appreciated for improving the English in the manuscript. The authors also thank the children and their parents for their voluntary participation in this study. We also thank Dr. Soliman Mohammadi Samani for providing the placebo tablets.

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Authors and Affiliations

  1. Research Center for Psychiatry and Behavioral Sciences, Shiraz University of Medical Sciences, School of Medicine, Shiraz, Iran

    Ahmad Ghanizadeh

  2. Department of Psychiatry, Shiraz University of Medical Sciences, School of Medicine, Shiraz, Iran

    Ahmad Ghanizadeh & Rezvan Haghighat

  3. Research Center for Psychiatry and Behavioral Sciences, Department of Psychiatry, Shiraz University of Medical Sciences, School of Medicine, Shiraz, Iran

    Ahmad Ghanizadeh

Authors
  1. Ahmad Ghanizadeh
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  2. Rezvan Haghighat
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Corresponding author

Correspondence to Ahmad Ghanizadeh.

Additional information

Trial registration: This study is registered at the Iranian Registry of Clinical Trials (IRCT201111043930N16).

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Ghanizadeh, A., Haghighat, R. Nortriptyline for treating enuresis in ADHD—a randomized double-blind controlled clinical trial. Pediatr Nephrol 27, 2091–2097 (2012). https://doi.org/10.1007/s00467-012-2211-z

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  • DOI: https://doi.org/10.1007/s00467-012-2211-z

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