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Plasma Concentration and Clinical Effect in Imipramine Treatment of Childhood Enuresis

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Summary

The relationship between steady-state plasma concentration and clinical effect of impramine in the treatment of nocturnal enuresis was studied in 22 hospitalised children. After 1 week on placebo the children were given imipramine in a fixed dose of about 1mg/kg for 3 weeks. The enuresis frequency decreased significantly from the placebo to the first week on imipramine, but then no further improvement was observed.

There was a significant correlation between steady-state plasma concentration of desipramine or imipramine + desipramine and the reduction in enuresis frequency during imipramine treatment. The optimum effect was obtained when steady-state levels of imipramine + desipramine were above 60μg/L; i.e. the effective concentration in enuresis is 3 to 4 times lower than in antidepressive therapy.

Dose- and weight-corrected, steady-state plasma concentration of imipramine and desipramine were not significantly different from those previously observed in younger adults. In I child, a transient rise in Imipramine and desipramine concentration was seen during a period with fever and bacterial infection.

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References

  • Blackwell, B. and Currah, J.: The psychopharmacology of nocturnal enuresis; in Kolvin, MacKeith and Meadow (Eds) Bladder Control and Enuresis, pp. 231–257 (Lippincott, Philadelphia 1973).

    Google Scholar 

  • Drew, L.R.H.: Control of enuresis by Imipramine. Medical Journal of Australia 53: 1225–1227 (1966).

    Google Scholar 

  • Gram, L.F.: Plasma level monitoring of tricyclic antidepressant therapy. Clinical Pharmacokinetics 2: 237–251 (1977).

    Article  PubMed  CAS  Google Scholar 

  • Gram, L.F.; Sondergaard, I.; Christiansen, J.; Odden Petersen, G.; Bech, P.; Reisby, N.; Ibsen, I.; Ortmann, J.; Nagy, A.; Dencker, S.J.; Jacobsen, O. and Krautwald, O.: Steady-state kinetics of Imipramine in patients. Psychopharmacology 54: 255–261 (1977).

    Article  PubMed  CAS  Google Scholar 

  • Hagglund. T.-B. and Parkkulainen, K.V.: Enuretic children treated with Imipramine (Tofranil®). Annales Paediatricae Fenniae 11: 53–59 (1964).

    Google Scholar 

  • Jorgensen, O.S.: Psychopharmacological treatment of psychotic children: A survey. Acta Psychiatrica Scandinavica 59: 229–238 (1979).

    Article  PubMed  CAS  Google Scholar 

  • Kardash, S.; Hillman, E.S. and Werry, J.: Efficacy of Imipramine in childhood enuresis: A double-blind control study with placebo. Canadian Medical Association 99: 263–266 (1968).

    CAS  Google Scholar 

  • Maxwell, C. and Seldrup, J.: Factors relating to the optimum effect of Imipramine in the treatment of enuresis. Arzneimittel-Forschung 21: 1352–1356 (1971).

    PubMed  CAS  Google Scholar 

  • Nagy, A. and Treiber, L.: Quantitative determination of Imipramine and desipramine in human blood by direct densitometry of thin-layer chromatography. Journal of Pharmacy and Pharmacology 25: 599–603 (1973).

    Article  PubMed  CAS  Google Scholar 

  • Piafsky, K.M. and Borga, O.: Plasma protein binding of basic drugs. II. Importance of α1-acid glycoprotein for interin-dividual variation. Clinical Pharmacology and Therapeutics 22: 545–549 (1977).

    PubMed  CAS  Google Scholar 

  • Poussaint, A.F. and Ditman, K.S.: A controlled study of Imipramine (Tofranil®) in the treatment of childhood enuresis. Journal of Pediatrics 65: 283–290 (1965).

    Google Scholar 

  • Reisby, N.; Gram, L.F.; Bech, P.; Nagy, A.; Odden Petersen, G.; Ortmann, J.; Ibsen, I.; Dencker, S.J.; Jacobsen, O.; Krautwald, O.; Sondergaard, I. and Christiansen, J.: Imipramine: Clinical effects and pharmacokinetic variability. Psychopharmacology 54: 263–272 (1977).

    Article  PubMed  CAS  Google Scholar 

  • Spiker, D.G.; Weiss, A.N.; Chang, S.S.; Ruwitch, J.F. and Biggs, J.T.: Tricyclic antidepressant overdose: Clinical presentation and plasma levels. Clinical Pharmacology and Therapeutics 18: 539–546 (1975).

    PubMed  CAS  Google Scholar 

  • Winsberg, B.G.; Perel, J.M.; Jurwic, M.J. and Klutch, A.: Imipramine protein binding and pharmacokinetics in children; in Forrest, Carr and Usdin (Eds) The Phenothiazines and Structurally Related Drugs, pp. 425–431 (Raven Press, New York 1974).

    Google Scholar 

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Authors and Affiliations

  1. Department of Pediatrics, Copenhagen County Hospital, Glostrup, Denmark

    Ole Sylvester Jorgensen, Marianne Lober, Johannes Christiansen &  Lars F. Gram

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  1. Ole Sylvester Jorgensen
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  2. Marianne Lober
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  3. Johannes Christiansen
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  4. Lars F. Gram
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Jorgensen, O.S., Lober, M., Christiansen, J. et al. Plasma Concentration and Clinical Effect in Imipramine Treatment of Childhood Enuresis. Clin Pharmacokinet 5, 386–393 (1980). https://doi.org/10.2165/00003088-198005040-00006

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  • DOI: https://doi.org/10.2165/00003088-198005040-00006

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