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The Effect of Single Dose Imipramine on Nocturnal Urine Output in Patients with Nocturnal Enuresis

Journal of the Korean Pediatric Society 2000;43(6):792-797.
Published online June 15, 2000.
The Effect of Single Dose Imipramine on Nocturnal Urine Output in Patients with Nocturnal Enuresis
Won Jung Kim, Min Jung Kim, Byeong Hee Son, Sung Won Kim
Department of Pediatrics, St. Benedict Hospital, Pusan, Korea
야뇨증 환아에서 Imipramine의 단독 투여에 의한 야간 요량의 변화
김원정, 김민정, 손병희, 김성원
부산성분도병원 소아과
Abstract
Purpose
: The aim of the present study was to investigate the effect of single dose imipramine on nocturnal urine output in patients with nocturnal enuresis.
Methods
: A total of 6 monosymptomatic enuretic patients of more than 5 years of age were enrolled in this study. We measured nocturnal urine output, urine osmolality, creatinine clearance, osmolal clearance, excretion rate of solutes, fractional excretion of sodium and potassium, and plasma vasopressin with and without a single oral dose of imipramine(1mg/kg of body weight) at 8 p.m.
Results
: The administration of imipramine was followed by a significant decrease in nocturnal urine output(P=0.02). Urine osmolality was not significantly increased(P>0.05), but osmolal clearance was significantly decreased during imipramine medication(P=0.03). Urinary excretion rate of sodium and potassium showed a statistically insignificant trend toward lower values during imipramine administration in nocturnal enuretics. Fractional urinary excretion of sodium and potassium was significantly decreased during imipramine medication(P<0.05). There was no significant difference in plasma vasopressin level and creatinine clearance in nocturnal enuretics after imipramine.
Conclusion
: Imipramine has a vasopressin independent antidiuretic effect in patients with nocturnal enuresis. The antidiuretic effect of imipramine can be attributed primarily to increased α- adrenergic stimulation in the proximal tubules with secondary increased urea and water reabsorption more distally in the nephron.
Key Words: Imipramine, Enuresis


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