Twenty two patients with multiple sclerosis, complaining offrequency of day time micturition, completed a double blind crossover trial of desmopressin (DDAVP nasal spray) versus placebo. There was asignificant decrease in micturition frequency in the 6 hour post-treatment period from 3.1 voids after placebo to 2.4 voids and asignificant reduction in urinary volume after desmopressin. Eighty percent of patients preferred the active treatment phase. Mean 24 hoururinary volume did not differ between active and placebo treatments andpatients did not complain of increased night time frequency. Transientsymptoms of hyponatraemia occurred in one patient but these resolvedwithin 48 hours of stopping desmopressin. There were otherwise no sideeffects and mean serum sodium concentrations of the groupremained unchanged throughout the study. The clinical indications forprescribing daytime desmopressin are discussed and the importance ofpatient compliance stressed.
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