Reducing nocturia in the elderly: a randomized placebo-controlled trial of staggered furosemide and desmopressin.

Abstract

AIMS:

The purpose of this study was to investigate efficacy, safety, and impact on quality of sleep of staggered furosemide and desmopressin in the treatment of nocturia in the elderly.

METHODS:

Patients aged >60 years with nocturia at least two voids per night were screened for enrollment into the study. A 3-week dose-titration phase established the optimum desmopressin dose (0.1, 0.2, or 0.4 mg). After a 1-week "washout" period, patients who showed sufficient response during the dose-titration period were randomized to receive staggered furosemide and the optimal dose of desmopressin or placebo in a double-blind design for 3 weeks. Voiding diaries were assessed before and after the treatment.

RESULTS:

In all, 82 patients were randomized to either staggered furosemide and desmopressin (n=41) or placebo (n=41). In the study group, most patients reported a good response with both reduced nocturnal voids (3.5 vs. 2.0, P<0.01) and urine volume (919.6 ml vs. 584.2 ml, P<0.01). The mean duration of the first sleep period was improved by 70 min (133.6 vs. 203.2, P<0.01). Compared to placebo, staggered furosemide and desmopressin resulted in a significant reduction in the mean number of nocturnal voids (43% vs. 9%; P<0.01), nocturnal urine volume (37% vs. 5%; P<0.01), and increase in the mean duration of the first sleep period (52% vs. 19%, P<0.01). Adverse events were mild.

CONCLUSIONS:

Staggered furosemide and desmopressin provide an effective and well-tolerated treatment for nocturia in the elderly.

• Authors: Fei-Guo Fu, Hugh J Lavery, Deng-Long Wu
• Journal: Neurourology and urodynamics (Neurourol Urodyn) Vol. 30 Issue 3 Pg. 312-6 (Mar 2011) ISSN: 1520-6777 [Electronic] United States
• PMID: 21305590 (Publication Type: Journal Article, Randomized Controlled Trial)
• Copyright: Copyright © 2011 Wiley-Liss, Inc.

Chemical References

• Diuretics
• Furosemide
• Deamino Arginine Vasopressin

Topics

• Age Factors
• Aged
• Aged, 80 and over
• China
• Deamino Arginine Vasopressin (administration & dosage, adverse effects)
• Diuretics (administration & dosage, adverse effects)
• Double-Blind Method
• Drug Administration Schedule
• Drug Therapy, Combination
• Female
• Furosemide (administration & dosage, adverse effects)
• Humans
• Male
• Middle Aged
• Nocturia (drug therapy, physiopathology)
• Placebo Effect
• Sleep (drug effects)
• Time Factors
• Treatment Outcome
• Urodynamics (drug effects)