Bedwetting and Medication

Related Content

• Bedwetting: How to Help Your Child

By Sara Dimerman

One of the treatments for bedwetting is the very popular Alarm Urination device. However, sometimes this does not work as hoped or parents choose not to explore this option for any number of reasons. Some parents, in consultation with a medical doctor, may decide on medication as their choice of treatment. The medications of choice for enuresis (bedwetting) are imipramine (Tofranil) and desmopressin (DDAVP). Each medication has side effects that should be carefully investigated and considered prior to use.

Imipramine is approved for use with children as young as six years of age and in a study, conducted in 1984, was found to be more effective than a placebo (when the patient and parents believed that they were receiving the medication but instead they were receiving a sugar pill that had no medicinal effect). Since imipramine is actually an anti-depressant, it is not entirely clear as to why it prevents enuresis. There is a lot of speculation as to why this occurs. Since there may be significant side effects, caution is advised when using it and the child should be closely monitored by a medical doctor.

Desmopressin, which is administered as a nasal spray or in tablet form, has an antidiuretic effect that significantly reduces bedwetting. Sometimes, a lack of a natural anti-diuretic hormone (ADH) called vasopressin released from the brain can lead to bed wetting. This hormone makes the urine more concentrated and reduces the production of urine at night. Desmopressin is a synthetic hormone which helps the child's body produce less urine and therefore lessens the chance that the child's bladder will overfill during sleep. Research conducted in the mid 1990's indicated that one quarter to one half of all bedwetting children taking desmospressin were completely dry at night while taking the medication. However, once stopped, many children resumed bedwetting. It was found that overall, the medication appears to be less effective than the Urine Alarm system. When compared to Imipramine, Desmopressin was found to be a safer choice with less side effects.

It may be useful to try a behaviour modification program before using medication. However, since medication may be more of a quick fix so long as the patient continues use of the drug, it may initially be more useful for children that are particularly distressed by the bedwetting and want it to stop quickly rather than spending more time trying to stop the behaviour through other treatment methods. At the very least, it has been found that if you combine a behavioural training program with the medication, there are more lasting effects after medication has been stopped.

Most literature reports that medication is a quick fix, not a cure for enuresis and should be considered last on the list of options.