Medications

In general, medications are used in bedwetting for two reasons — to either increase bladder capacity or to reduce the amount of urine produced by the kidneys. No medication "cures" enuresis, however they serve a useful role for some children on a short term basis to help them get to the point where they are able to wake at night on their own and void. The use of medications in combination with alarms is well documented (1-6). In addition, the use of desmopressin acetate (DDAVP) for symptomatic relief (i.e. dry night) has increasingly gained acceptance for use on an as-needed basis for children who need temporary relief of enuresis, such as for sleepovers and camps.

Desmopressin Acetate (DDAVP™) — Desmopressin acetate is a synthetic version of antidiuretic hormone (ADH), a hormone produced by the body's pituitary gland that affects the kidney's urine production. In children without enuresis, ADH typically increases during the night and reduces the amount of urine produced (7,8). The administration of either the nasal inhalation or tablet, before bed, reduces urine production at night.

Oxybutynin (Ditropan™) — Oxybutynin is an anticholinergic (antispasmodic) medication that relaxes smooth muscle and therefore reduces the bladder's ability to contract (9). It helps decrease muscle spasms of the bladder and the frequent urge to urinate caused by these spasms.

Imipramine — Imipramine is from the medication class known as tricyclic antidepressants. These agents have been used widely over the past twenty years for primary nocturnal enuresis, although their specific mechanism of action (10) is not well established. They have fallen out of favor due to their potential for major side effects and the danger they present for accidental overdose (11,12).

 

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