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[The treatment of nocturnal enuresis in children]
Insights
Differentiated treatment for nocturnal enuresis (NE) in children, considering sleep disturbances, led to higher remission rates. This approach significantly outperformed standard amitriptyline or imipramine monotherapy for childhood NE.
Area of Science:
- Pediatrics
- Sleep Medicine
- Pharmacology
Background:
- Nocturnal enuresis (NE) is a common condition in children.
- Standard treatments like amitriptyline and imipramine have varying efficacy.
- The role of coexisting sleep disturbances in NE treatment outcomes is not fully elucidated.
Purpose of the Study:
- To evaluate the efficacy of a differentiated treatment strategy for childhood nocturnal enuresis.
- To compare the outcomes of differentiated treatment with standard monotherapy using amitriptyline or imipramine.
- To assess the impact of addressing coexisting sleep disturbances on NE remission rates.
Main Methods:
- A randomized study involving 367 children with nocturnal enuresis.
- Group 1: treated with amitriptyline.
- Group 2: treated with imipramine.
- Group 3: received differentiated treatment based on clinical sleep disturbances, including amitriptyline, imipramine, diazepam, and nootropic drugs (pyracetam, pantogam).
Main Results:
- After 3 months, the differentiated treatment group (Group 3) achieved a complete remission rate of 68.3%.
- Amitriptyline monotherapy (Group 1) resulted in a 20.9% remission rate.
- Imipramine monotherapy (Group 2) achieved a 45.6% remission rate.
- The differentiated approach showed significantly better outcomes compared to monotherapy.
Conclusions:
- Differentiated pharmacotherapy, tailored to individual sleep disturbances, is a more effective strategy for treating childhood nocturnal enuresis.
- Addressing coexisting sleep issues alongside NE is crucial for improving treatment success.
- This individualized approach offers a promising alternative to standard monotherapies for pediatric NE.
Abstract:
367 children with nocturnal enuresis (NE) were divided into randomly selected groups. Two groups were treated with amitriptylin (the 1st group) or imipramine (the 2nd one). In the third group the treatment was differentiated and depended on coexist clinical sleep disturbances. In such cases there were used according to indications amitriptylin (including in combination with cyclodol), imipramine, diazepam. Additionally nootropic drugs (pyracetam, pantogam) were also administrated. In 3 month after the treatment 68.3% of the patients of the 3rd group still had complete remission. These results were better then in the 1st (20.9%) and in the 2nd (45.6%) groups of patients in which the treatment of NE was not depended on coexist disturbances.