ORIGINAL ARTICLE   

Minerva Pediatrica 2019 April;71(2):135-8

DOI: 10.23736/S0026-4946.17.04680-1

Copyright © 2017 EDIZIONI MINERVA MEDICA

lingua: Inglese

Attention-deficit/hyperactivity disorder and enuresis: a study about effectiveness of treatment with methylphenidate or desmopressin in a pediatric population

Pietro FERRARA ^{1, 2} ✉, Valeria SANNICANDRO ¹, Francesca IANNIELLO ¹, Enrica QUATTROCCHI ², Annamaria SBORDONE ², Tommasangelo PETITTI ³, Paolo MARIOTTI ⁴

¹ Institute of Pediatrics, Catholic University Medical School, Rome, Italy; ² Service of Pediatrics, Campus Bio-Medico University, Rome, Italy; ³ Public Health and Statistics, Campus Bio-Medico University, Rome, Italy; ⁴ Unit of Child Neuropsychiatry, Catholic University Medical School, Rome, Italy

BACKGROUND: The aim of this study was to evaluate the effectiveness of treatment with methylphenidate or desmopressin (dDAVP) in patients with comorbid attention-deficit/hyperactivity disorder (ADHD) and enuresis.
METHODS: We enrolled 103 patients affected by ADHD and 125 patients with monosymptomatic nocturnal enuresis (NE). Data were collected between January 2014 and December 2015. The study was carried out in compliance with the Helsinki Declaration.
RESULTS: About children with ADHD, 9/103 (8.7%) were also suffering from NE; of those 8/9 followed treatment with methylphenidate and cognitive behavioral therapy. After 3 months 2/8 (25%, CI 95%: 8-65%) showed improvements, remaining 75% has been increased dosage of methylphenidate. After 6 months a response was achieved in 6/8 (75%, CI 95%: 35-96%) children and 1/8 was lost to follow-up. Furthermore the drug withdrawal showed a recurrence of symptoms both ADHD and NE in 1/7 (14.3%, CI 95%: 0.3-57%) vs. 6/7 (85.7%, CI 95%: 42-99%) that not presented recurrences. About children with NE enrolled at Campus Bio-Medico University it was found that 4/125 (3.8%) children were also suffering from ADHD; 3/4 (75%) treated with dDAVP and motivational therapy, of those 2/3 (66.7%, CI 95%: 9-99%) showed no improvements of symptoms vs. 1/3 (33.3%, CI 95%: 0.8-90%) that showed partial response with a reduction of wet-nights.
CONCLUSIONS: It is important the service of recruitment of patients with NE. In fact considering NE in a Child Neuropsychiatry Service where patients belong to a diagnosis of ADHD and NE is an incidental finding, this one is not considered as the addressee of treatment, but the therapy is directed to the neuro-behavioral problem using specific drugs and therapies, which are resolutive in the enuretic disorder.

KEY WORDS: Attention deficit disorder with hyperactivity - Enuresis - Methylphenidate - Deamino arginine vasopressin