Comparison of the efficacy of fluvoxamine and desmopressin-oxybutynin combination in the treatment of nocturnal enuresis: A clinical trial


1 Assistant Professor of Pediatrics, Department of Pediatrics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

2 Kidney Transplantation Complication Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.

3 Department of Pediatrics, Mashhad University of Medical Sciences, Mashhad, Iran.

4 Department of Community Medicine, Mashhad Branch, Islamic Azad University, Mashhad, Iran.


Primary nocturnal enuresis (PNE), with a prevalence of 5-30%, is a common and important disease in children. The aim of the present study was to investigate the efficacy of fluvoxamine in the treatment of refractory PNE and to compare it with standard desmopressin-oxybutynin treatment.
A total of 30 children aged above 8 years with PNE referred to the Nephrology Clinic of Dr. Sheikh Hospital (Mashhad) who were resistant to the first line of behavioral and drug treatment and did not have any other psychological disorders were enrolled in the present pilot clinical trial. Patients were divided into fluvoxamine (25 mg at bedtime for one month) and combination therapy (desmopressin, 10μg intranasal) and oxybutynin (0.1 mg/kg for one month). The recovery status of patients in the two groups was investigated and compared as the main outcome of the study based on the number of wet nights during one month.
A total of 30 patients with PNE were included in the present study. Three patients of the treatment group were excluded from the study due to lack of referral and follow-up. At the end of follow-up in the fluvoxamine treatment group, full recovery was observed in 8 patients (66.7%), partial recovery in 2 patients (16.7%), and no recovery in 2 patients (16.7%). Also, the desmopressin-oxybutynin treatment resulted in full recovery in 7 patients (46.7%), partial recovery in 4 patients (26.7%), and no recovery in 4 patients (26.7%), but there was no significant difference between the two groups in terms of therapeutic results (P> 0.05).