DESMOPRESSIN IN THE TREATMENT OF NOCTURIA AND ENURESIS IN PATIENTS WITH MULTIPLE-SCLEROSIS

Objectives To assess whether the synthetic vasopressin analogue desmopressin [1-desamino 8-D-arginine vasopressin] is efficacious and safe in the management of nocturia+/-enuresis in patients with multiple sclerosis. Patients and methods Twenty-two women and 11 men, under 65 years of age, with clinically definite multiple sclerosis and nocturnal frequency+/-enuresis were entered into the study. A two week placebo run-in, to establish normal voiding patterns, followed by a double-blind, placebo-controlled, cross-over study of 20 mu g intranasal desmopressin at night-time was carried out. Results Desmopressin caused a significant decrease in nocturnal urinary frequency, nocturnal urinary volume and the percentage of total daily urine passed at night, There was no significant fall in plasma sodium with desmopressin although there were two cases of asymptomatic hyponatraemia. Conclusion Desmopressin is an efficacious and safe treatment for nocturia+/-enuresis in patients with multiple sclerosis.