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Plasma levels and efficacy of imipramine treatment for enuresis.

AbstractOBJECTIVE:
To determine the relationship between serum drug level and treatment efficacy in enuretic children treated with imipramine (IMI).
METHOD:
Eighteen children with primary nocturnal enuresis recruited from an ambulatory enuresis clinic population were the subjects of the study. After a baseline period of 2 weeks, children received placebo for 1 week followed by treatment with IMI in increasing dosages (1.0 mg/kg, 1.5 mg/kg, 2.0 mg/kg, and 2.5 mg/kg), each dosage being given for 2 weeks. Steady state IMI and desipramine levels were determined in each child for each dosage. Medication response ([drug % dryness-placebo % dryness] divided by [100%-placebo % dryness]) was determined for each dosing interval.
RESULTS:
Average dryness increased from 27.8% on placebo to 73% with 2.5 mg/kg of IMI. The overall correlation between medication response and combined serum level was .26 (p < .05). Side effects were monitored throughout the study and were found to be rare.
CONCLUSIONS:
The efficacy of IMI over placebo in reducing the frequency of nocturnal enuresis in children was confirmed. Efficacy was moderately but significantly related to increasing mg/kg dose. A higher serum level tended to be associated with a better response, but there was at least 700% variation in serum level between subjects at every dosage. Monitoring serum levels of imipramine in children with idiopathic functional nocturnal enuresis treated with that medication has a limited but real usefulness in clinical management.
AuthorsG K Fritz, R M Rockney, A S Yeung
JournalJournal of the American Academy of Child and Adolescent Psychiatry (J Am Acad Child Adolesc Psychiatry) Vol. 33 Issue 1 Pg. 60-4 (Jan 1994) ISSN: 0890-8567 [Print] UNITED STATES
PMID8138522 (Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial)
Chemical References
  • Imipramine
  • Desipramine
Topics
  • Adolescent
  • Ambulatory Care
  • Child
  • Desipramine (pharmacokinetics)
  • Dose-Response Relationship, Drug
  • Enuresis (blood, drug therapy)
  • Female
  • Humans
  • Imipramine (adverse effects, pharmacokinetics, therapeutic use)
  • Male
  • Single-Blind Method
  • Treatment Outcome

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