Should a child with nocturnal enuresis be treated with drugs?

One method of treating bedwetting available to parents for their child is prescribed drugs. 

There are two types of drugs usually prescribed by physicians:

  • Synthetic hormones like Desmopressin which perform the same function as anti-diuretic hormone which our body produces at night time to stop us over-producing urine during sleep;
  • Tricyclic anti-depressants like Imipramine which have a relaxing effect on the bladder, allowing it to hold more urine comfortably and prevent the automatic voiding of the bladder when it is full.
Drug treatment is relatively expensive and runs the risk of uncommon but severe side effects.

The downsides of bed wetting prevention drugs

Desmopressin comes as a nasal spray or pill and is taken before bedtime. The dose is adjusted until effective. Once it is working, the dose is tapered, if possible.

In the case of Desmopressin it needs to be used with great caution in children who have problems with fluid balance or cystic fibrosis because excessive fluid intake can affect the fluid balance in the brain leading to confusion or even convulsions. Also, it tends to be ineffective with children with viral or symptomatic allergic rhinitis. Side effects may include headaches, runny nose, nasal stuffiness and nosebleeds.

Imipramine is prescribed in pill form. It can lead to emotional irritability in children. Side effects may include nervousness, anxiety, constipation and personality change. There is also the possibility of accidental overdose which can lead to convulsions and coma. Deaths have been attributed to accidental overdoses.

Desmopressin can be effective for short-term treatment when on camp or sleepovers and Imipramine can be effective for short term treatment of distressed, older children if other treatments have been unsuccessful.

Drugs do not cure bedwetting long term.

Once a child stops taking them the symptoms usually return.

Because bedwetting is not a disease or symptomatic of a serious underlying condition, in most cases, treating it with prescription drugs which can have significant side-effects in some patients, should be strictly monitored. The majority of parents we talk to do not want to medicate their bedwetting children for this reason. 

Although few studies have examined the effectiveness of specific homeopathic therapies, professional homeopaths offer remedies based on their knowledge and experience. In many cases homeopathic treatments are provided in solutions which contain alcohol and, similar to drug treatment, the symptoms usually return once the child stops taking the remedy.

Bedwetting alarms are the safest and most effective treatment for nocturnal enuresis. They are not as costly as drug treatments and provide a long term solution based on behavioural therapy rather than a short term medical solution.  

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Lydia and her girls

My daughter loves the alarm. She’s told me to ‘sell my pull-ups on eBay mommy’. She just loves that she doesn’t have to wear pull-ups…

- Lydia Du Buisson, Canada