cover image: Treatment options for clozapine-induced enuresis

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Treatment options for clozapine-induced enuresis

27 Sep 2010

The product monograph clearly indicates that desmopressin is contraindicated in patients with known hyponatremia.8 Two articles17,18 reported that no adverse events occurred with desmopressin treatment and three failed to report this information.4,16,19 The most common dosage was 10 μg/day in each nostril which is consistent with the average daily doses reported in the product monograph for desmop [...] The dosage was consistent with recommendations in the product monograph for oxybutynin.10 Frankenburg et al (1996)17 reported that no adverse events occurred with oxybutynin treatment and Lurie et al (1997)16 did not report the occurrence of adverse events in their study.16 Trihexiphenidyl, another anticholinergic agent, was reported to be effective at doses of 5 mg/day and 6 mg/day (n = 3).20,21 [...] Antipsychotics Aripiprazole was used to treat three patients with clozapine-induced nocturnal enuresis at doses of 10-15 mg/day.13,14 The authors of these cases reported that the treatment was effective within 1 to 3 months. [...] Rocha et al (2006)13 reported that no adverse events occurred after initiating treatment with aripiprazole and Lee and Kim (2010) did not report whether or not the patients experienced any adverse events.14 Another case involved ceasing treatment with clozapine and commencing therapy with olanzapine.23 The authors reported that the nocturnal enuresis remitted following this change in pharmacothera [...] The patient experienced bradycardia (reduction of 11-22 beats/min) for five days after the first dose of 40 mg/day verapamil and for 4 days following the first dose of 80 mg/day verapamil.
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10
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Canada

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