Methylphenidate enuresis

In six children aged 6-15 years with co-morbid enuresis and attention deficit/hyperactivity disorder (ADHD), which had failed to respond to methylphenidate, reboxetine 4-8 mg/day for 6 weeks reduced the frequency of bedwetting from an average of five times a week to once a week (4). Reboxetine was generally well-tolerated,... 

OTHER THERAPEUTIC USES OE THESE DRUGS The various antidepressant agents have found broad utility in other disorders that may not be related psychobiologicaUy to the mood disorders. Current applications include rapid but temporary suppression of enuresis with low (e.g., 25 mg) pre-bedtime doses of tricyclic antidepressants, including imipramine and nortriptyline, by uncertain mechanisms in children and in geriatric patients, as well as a beneficial effect of duloxetine on urinary stress incontinence. Antidepressants have a growing role in attention-deficit/hyperactivity disorder in children and adults, for which imipramine, desipramine, and nortriptyline appear to be effective, even in patients responding poorly to or who are intolerant of the stimulants (e.g., methylphenidate). Newer NE selective reuptake inhibitors also may be useful in this disorder atomoxetine is approved for this application. Utility of SSRIs in this syndrome is not established, and bupropion, despite its similarity to stimulants, appears to have limited efficacy. 

Urinary tract A possible association of methylphenidate and enuresis has been reported [63 ]. 

An 11-year-old boy with ADHD was given methylphenidate and after the daily dosage had been titrated to 20 mg enuresis started to occur. After 2 months, the medication was withdrawn and the enuresis stopped immediately. About 1 month later, methylphenidate was restarted and the enuresis reoccurred when the dose reached 20 mg/day. It continued for about 3 months but immediately stopped when the medication was withdrawn. Another rechallenge after 2 months, followed by withdrawal of methylphenidate, replicated the response. Other causes of enuresis were excluded and the patient never had daytime urinary incontinence. 

Ghanizadeh A. Methylphenidate-associated enuresis in attention deficit hyperactivity disorder. J Pediatr Urol 2008 4 306-7. 

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