There was not enough evidence to judge whether or not the included drugs cured bedwetting when used alone. There was limited evidence to suggest that desmopressin, imipramine and enuresis alarms therapy were better than the included drugs to which they were compared. In other reviews, desmopressin, tricyclics and alarm interventions have been shown to be effective during treatment. There was also evidence to suggest that combination therapy with anticholinergic therapy increased the efficacy of other established therapies such as imipramine, desmopressin and enuresis alarms by reducing the relapse rates, by about 20%, although it was not possible to identify the characteristics of children who would benefit from combination therapy. Future studies should evaluate the role of combination therapy against established treatments in rigorous and adequately powered trials.
Treatment of nocturnal enuresis: a placebo-controlled trial with piracetam, diphenylhydantoin and psychotherapy.
The study population consisted of 100 children with nocturnal enuresis (NE) aged between six and 14 years, who had been randomly selected amongst the enuretic outpatients at the Ankara S.S.K. Children's Hospital. A placebo-controlled evaluation of piracetam, diphenylhydantoin and psychotherapy was carried out. At the end of the eighth week of the study, it was discovered that the therapeutic effects observed in the patients administered piracetam did not differ from those given the placebo. Therefore, we recommend that psychotherapy in association with a placebo be the first step in the treatment of NE children.