Desmopressin-Responsive Nocturnal Enuresis Following Guanfacine Treatment in a Child with ADHD

Mustafa Tolga Tunagür; Enes Sarıgedik

doi:10.58600/eurjther2670

Authors

Mustafa Tolga Tunagür Department of Child and Adolescent Psychiatry, Faculty of Medicine, Sakarya University, Sakarya, Türkiye https://orcid.org/0000-0002-8418-4745
Enes Sarıgedik Department of Child and Adolescent Psychiatry, Faculty of Medicine, Sakarya University, Sakarya, Türkiye https://orcid.org/0000-0002-9294-1152

DOI:

https://doi.org/10.58600/eurjther2670

Keywords:

guanfacine, enuresis nocturna, ADHD, desmopressin

Abstract

The documents a unique instance of guanfacine-induced secondary nocturnal enuresis in an 8-year-old boy diagnosed with Attention Deficit/Hyperactivity Disorder (ADHD). In this case, an 8-year-old boy with ADHD and a history of Ventricular Septal Defect surgery was treated with guanfacine XR 1 mg/day. Within three days, the boy experienced intermittent nocturnal enuresis. Despite partial ADHD symptom improvement with a dose increase to 2 mg/day, nocturnal enuresis worsened (up to four times a week). Subsequent dose reductions and additions of desmopressin partially alleviated enuresis symptoms. Notably, ADHD symptoms remitted with a dose escalation to 3 mg/day but were accompanied by increased enuresis frequency. Significant improvement was achieved through dose adjustments and the introduction of desmopressin, highlighting a potential management strategy for this side effect.

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