Two medications have been recognized as potentially helpful in controlling bedwetting. The use of either requires a doctor’s prescription and a thorough understanding of potential benefits, risks, and proper use. Consider these important points before using either of these drugs:
- They are best suited for children who are at least eight years old and for whom other methods have not been consistently successful.
- In many cases they provide temporary assistance rather than a permanent cure. Enuresis often resumes when a medication is discontinued (especially if done abruptly) unless other training methods have been utilized as well. Long-term use of medication might be considered in specific situations – for example, an older child or adolescent with persistent enuresis – depending upon the underlying cause.
- They can be very helpful for the child who wants to participate in activities such as camp-outs or sleepovers with friends or relatives without worrying about wetting the bed or sleeping bag.
- Either drug should be tried at home to check for effectiveness or side effects before being used on an overnight outing.
Imipramine (Tofranil and other brands) increases the bladder’s functional capacity and reduces its tendency to empty spontaneously. It is inexpensive and usually well tolerated when given in the proper dose, although it can cause anxiety and insomnia. The problem with this drug, however, is its toxicity in an accidental overdose, which can lead to seizures, or fatal heart-rhythm disturbances. If your child is going to take imipramine for enuresis, make sure he understands that he should never take more than what it has recommended, and the bottle should not be accessible to any other children.
Desmopressin (DDAVP) acts like the pituitary move vasopressin, reducing the amourine produced during the night. It is safe and easy to take (it comes only in a nasal spray), but obtained with it are inconsistencies, and enuresis mainly recurs when the drug is discontinued. It is expensive – well over $75 per month, compared to about $5 per month for generic imipramine. DDAVP can be particularly useful for the child or adolescent who needs some protection from bedwetting during an overnight outing without risk of unwanted side effects.
In summary, bedwetting can be a great source of going distress and discouragement for a child. It is therefore very important that a child understands these points:
- He will eventually grow out of this problem.
- He is not the only child who has ever dealt with bedwetting. (Perhaps Mom, Dad, or other relatives had enuresis as well. If this was the case, letting him know this will provide some reassurance.)
- His parents, siblings, and physician are all on team.
- There may be some effort involved in dealing with the wet pajamas and sheets but his participation is not a punishment.