The analysis revealed that desmopressin might significantly decrease the frequency of nocturnal voids , nocturnal urine volume and nocturnal diuresis , potentially result ing in an extended duration of the first sleep period and improved sleep quality .
The adverse effects of desmopressin were similar to those observed in the placebo group .
Conclusions Administered desmopressin was an effective and well-tolerated treatment for nocturia
Purpose The purpose of this analysis was to evaluate the efficacy and safety of desmopressin for the treatment of nocturia .
Desmopressin in the management of nocturia in patients with multiple sclerosis. A double-blind, crossover trial.
BACKGROUND Neurogenic bladder affects up to 80 % of patients with multiple sclerosis ( MS ) and , in 50 % of these patients , it is a significant cause of disability . The current management of neurogenic bladder , based on fluid restriction , anticholinergic agents , intermittent self-catheterization , and , in some cases , surgical intervention , often fails to relieve all symptoms . Furthermore , anticholinergic drugs have significant adverse effects and may be medically contraindicated . Nocturia is a particularly disabling symptom of neurogenic bladder ; by disrupting sleep patterns , it aggravates the chronic fatigue of MS , imposes serious dem and s on caregivers , and can lead to institutionalization . To evaluate a novel approach to the symptomatic management of nocturia in patients with MS , we have conducted a trial of desmopressin acetate ( 1-desamino-8-D-arginine vasopressin ) , a synthetic analogue of antidiuretic hormone . OBJECTIVE To evaluate the efficacy and short-term safety of desmopressin therapy in the symptomatic treatment of nocturia in patients with MS . METHODS Seventeen patients were enrolled in a double-blind , crossover trial of desmopressin administered at bedtime . Patients with both relapsing-remitting and chronic-progressive forms of MS were admitted . Night time voiding diaries were maintained for the 6 weeks of the trial ; similarly , serum electrolyte levels and plasma osmolality were measured twice weekly and urinalyses and urine cultures were performed weekly during the trial . RESULTS Desmopressin reduced the percentage of nights with nocturia in patients from 97 % to 66 % . The average number of episodes of nocturia per night in patients decreased from 2.35 to 1.09 and the maximum hours of sleep uninterrupted by nocturia increased from 3.74 to 5.77 . These results were highly significant . Four of the 17 patients discontinued participation in the study after developing asymptomatic or minimally symptomatic hyponatremia . CONCLUSIONS Desmopressin was found effective ; no tolerance and only minimal adverse effects have been observed . Our results suggest that desmopressin , either alone or in combination with other therapeutic modalities , is effective in the symptomatic management of nocturia in patients with MS . The only adverse effect attributed to desmopressin was hyponatremia , which occurred in 4 of 17 patients and appeared to be dose related
The analysis revealed that desmopressin might significantly decrease the frequency of nocturnal voids , nocturnal urine volume and nocturnal diuresis , potentially result ing in an extended duration of the first sleep period and improved sleep quality .
The adverse effects of desmopressin were similar to those observed in the placebo group .
Conclusions Administered desmopressin was an effective and well-tolerated treatment for nocturia
Purpose The purpose of this analysis was to evaluate the efficacy and safety of desmopressin for the treatment of nocturia .