The efficacy of atomoxetine and methylphenidate for urinary incontinence associated with attention-deficit hyperactivity disorder: A retrospective study

Purpose: Children with attention-deficit/hyperactivity disorder (ADHD) often experience urinary incontinence, yet few studies have examined the effects of ADHD medications on this condition. This study retrospectively evaluated the therapeutic effects of atomoxetine and methylphenidate on urinary incontinence in children with ADHD. Materials and methods: Twelve children (9 boys and 3 girls) aged 6.0 to 11.3 years (median 8.4 years) with ADHD and urinary incontinence were included. All had nocturnal enuresis, while 10 had daytime incontinence. Each child was treated with atomoxetine and/or methylphenidate, and symptoms were assessed using questionnaires, the ADHD-Rating Scale (ADHD-RS), and the Dysfunctional Voiding Symptom Score before and 3 months after treatment. Results: ADHD symptoms improved significantly, with ADHD-RS scores decreasing from 21.9 to 13.5 at home and from 21.4 to 15.4 at school ( P < 0.05). Nocturnal enuresis resolved in 5 of 12 children, and daytime incontinence disappeared in 7 of 10. The Dysfunctional Voiding Symptom Score improved from 8.4 to 4.2 ( P < 0.05). Conclusion: ADHD medications may improve both ADHD symptoms and urinary incontinence, suggesting a shared underlying neurophysiological mechanism. Screening for ADHD in older children with urinary incontinence and appropriate treatment may enhance their quality of life.