Evidence supporting the use of: Adrenergic amines
For the health condition: Bedwetting

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Synopsis

Source of validity: Scientific
Rating (out of 5): 3

Adrenergic amines, particularly the drug desmopressin and less commonly the non-selective adrenergic agonist ephedrine, have been used in the management of nocturnal enuresis (bedwetting) in children. The scientific rationale stems from their action on the sympathetic nervous system and, in the case of desmopressin, its antidiuretic effect. Desmopressin, a synthetic analogue of vasopressin (antidiuretic hormone), is not an adrenergic amine, but older adrenergic amines such as ephedrine and pseudoephedrine have been evaluated historically due to their ability to increase urethral sphincter tone by stimulating alpha-adrenergic receptors, thus reducing involuntary urine leakage during sleep.

There is moderate scientific evidence (supported by small-scale clinical trials and case series, particularly from the mid-20th century) indicating a modest benefit of adrenergic amines in reducing nocturnal enuresis frequency. However, their use has been largely supplanted by safer and more effective treatments such as desmopressin and behavioral interventions, owing to the side effect profile of adrenergic amines (including insomnia, increased blood pressure, and potential for misuse). Current clinical guidelines rarely recommend adrenergic amines for enuresis, but their historical use was based on documented physiological mechanisms and clinical experience, providing a scientific—though now largely outdated—basis for their application in this context.

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