Ramelteon combined with an [alpha]1-blocker decreases nocturia in men with benign prostatic hyperplasia

Background Nocturia is defined as waking one or more times during the night due to the urge to void. Recently, the effectiveness of several sedatives and analgesics for nocturia has been reported. We herein investigated the effects of ramelteon, an antioxidant and sleep inducer, on nocturia unrespon...

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Published in:BMC urology 2013-06, Vol.13
Main Authors: Kawahara, Takashi, Morita, Satoshi, Ito, Hiroki, Terao, Hideyuki, Sakata, Ryoko, Ishiguro, Hitoshi, Tanaka, Katsuyuki, Miyamoto, Hiroshi, Matsuzaki, Junichi, Kubota, Yoshinobu, Uemura, Hiroji
Format: Article
Language:English
Subjects:
Age
Bladder
Diabetes
Drug therapy
Hospitals
Hypertension
Hypertrophy
Men
Multivariate analysis
Older people
Patient outcomes
Patients
Prostate
Quality of life
Questionnaires
Ramelteon
Sleep
Statistical analysis
Urination disorders
Urology
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Summary:Background Nocturia is defined as waking one or more times during the night due to the urge to void. Recently, the effectiveness of several sedatives and analgesics for nocturia has been reported. We herein investigated the effects of ramelteon, an antioxidant and sleep inducer, on nocturia unresponsive to [alpha]1-blocker monotherapy in males with lower urinary tract symptoms (LUTS) as a pilot study. Methods Subjects were 19 patients who had LUTS suggestive of benign prostate hyperplasia, received [alpha].sub.1-blockers (tamsulosin, silodosin, or naftopidil), and continued to have two or more episodes of nocturia per night before starting ramelteon. Ramelteon at 8 mg once daily for one month was added to the [alpha].sub.1-blocker. A self-administered questionnaire including the International Prostate Symptom Score (IPSS), quality of life (QoL) index, Overactive Bladder Symptom Score (OABSS), and Nocturia Quality-of-Life Questionnaire (N-QOL) were assessed before and one month after starting ramelteon. Results The mean score on IPSS question 7 (nocturia) decreased significantly from 2.88 before starting ramelteon to 2.41 one month after starting the medication (P = 0.03). The mean total OABSS decreased significantly from 6.31 to 5.38 (P = 0.03), and the mean for OABSS question 2 (nighttime frequency of nocturia) also significantly decreased from 2.63 to 2.13 (P = 0.01). The mean total N-QOL score did not change significantly. Two patients had dizziness; the remaining patients had no adverse drug-related events. Conclusions Ramelteon in combination with an [alpha].sub.1-blocker could be a treatment option for reducing nocturia in men with BPH. Keywords: Ramelteon, Melatonin, Nocturia, Benign prostate hyperplasia, [alpha].sub.1-blocker
ISSN:1471-2490
1471-2490
DOI:10.1186/1471-2490-13-30