[P3-9] The efficacy of methylphenidate and atomoxetine forvoiding dysfunction associated with attention deficit hyperactivity disorder
[Hypothesis / aims of study] The voiding dysfunction such as daytime and/or nocturnal urinary incontinence, is common in children with attention deficit hyperactivity disorder (ADHD). However, only a few reports using conventional drugs, such as anti-cholinergic drug, desmopressin and imipramine, have been published about the treatment for these patients.In general, methylphenidate (MPH), a dopamine reuptake inhibitor, and atomoxetine (ATX), a selective norepinephrine reuptake inhibitor, are used for a treatment of ADHD. Thus we studiedabout the effectiveness of MPH and ATX for voiding dysfunctionin children with the ADHD.
[Study design, materials and methods] A total 11children, 9 boys and 2 girls, with the ADHD and daytime and/or nocturnal urinary incontinence were enrolled in this study. The children age was from 6.0 years to 10.9 years (median; 8.25 years). All children were medicated with MPH and/or ATX without anti-cholinergic drug, desmopressin or imipramine. Children were evaluated the attention, behaviour and voiding problems before and after 3 months the medication by using the questionnaire, ADHD Rating Scale-ⅣandDysfunctional VoidingSymptom Scale (DVSS).
[Results] Theirattention and behaviour were improved by the medication. ADHD Rating Scale was changed from 21.6 to 15.3 (p=0.0025). In regard to urinary incontinence, five of 11 nocturnal incontinence children were completely improved, and the frequency of that were reduced toone third in six children. Complete response of daytime urinary incontinence was achieved in seven out of 11 children. DVSS was significantly improved from 9.88 to 4.57 (p=0.014). No adverse events were observed.
[Study design, materials and methods] A total 11children, 9 boys and 2 girls, with the ADHD and daytime and/or nocturnal urinary incontinence were enrolled in this study. The children age was from 6.0 years to 10.9 years (median; 8.25 years). All children were medicated with MPH and/or ATX without anti-cholinergic drug, desmopressin or imipramine. Children were evaluated the attention, behaviour and voiding problems before and after 3 months the medication by using the questionnaire, ADHD Rating Scale-ⅣandDysfunctional VoidingSymptom Scale (DVSS).
[Results] Theirattention and behaviour were improved by the medication. ADHD Rating Scale was changed from 21.6 to 15.3 (p=0.0025). In regard to urinary incontinence, five of 11 nocturnal incontinence children were completely improved, and the frequency of that were reduced toone third in six children. Complete response of daytime urinary incontinence was achieved in seven out of 11 children. DVSS was significantly improved from 9.88 to 4.57 (p=0.014). No adverse events were observed.