Medications to Treat Bed Wetting

If your child wets the bed, you will want to try behavior modification first.

No one medication is able to cure bed wetting. The good news is that most children do tend to outgrow the habit of bed wetting. As they grow and mature, the muscles of a child’s bladder get stronger and therefore so do their ability to control their bladder functions. As well they do not tend to fall into as deep a sleep every night as they did when they were toddlers. Children often become more attuned to the brain’s message that the bladder needs to be emptied. In the meantime if bed wetting is a consistent and embarrassing problem for a child there are medications that can be prescribed by a doctor to help treat the problem.

The first drug that appeared on the market to help bed wetting was Imipramine (Tofranil). This drug helps to encourage a child’s restful sleep pattern while also improving the quality of the muscles of a child’s bladder during sleep. However studies have proven that this drug is only beneficial in approximately thirty percent of children who take it. Unfortunately after the medication is stopped often the bed wetting episodes begin all over again. This medication is generally not given to children who are under six years of age. Imipramine is considered to be a tricyclic antidepressant and is only available in tablet or capsule form. This drug has its share of side effects which could include anxiety, irritability, insomnia, moodiness and a loss of appetite. Those taking this drug must be carefully monitored by a doctor.

Desmopressin Acetate (DDAVP) is a synthetic version of the natural antidiuretic hormone that works to help the bladder manufacture less urine and by so doing there is a lesser chance that a child’s bladder will overfill and then spill out while he or she is sleeping. DDAVP “promotes water reabsorption, resulting in increased urine concentration and decreased output during sleep.” This drug is very safe and effective with a success rate of twenty-five to sixty-five percent. DDAVP is considered to be safer than Imipramine but it is more costly. However while there can be side effects they are for the most part minimal. This medication can be administered either in tablet form (approximately a 0.2 milligram tablet before bedtime for a period of one week to start) or as a nasal spray. The medication generally goes to work very fast and if it is beneficial to the patient it can be used every week for a period of three to six months and then gradually decreased. For example, it can go from a schedule of seven days a week to five to three or four to two and finally to none.

While there are other drugs that be prescribed by a physician the two described above are the most common. It is important to discuss with a doctor whether or not bed wetting is serious enough to require medication or whether you can weather the storm until it passes. It is important to try not to become too filled with tension over bed wetting as this can make the problem ten times worse.

Medications and Side effects

Before deciding to give your child medication, carefully weigh the risks and advantages, as many medications or drugs have side effects:

DDAVP (Desmopressin Acetate) can help some children

DDAVP is a medication that can help some children stop wetting the bed. This medication works by reducing the amount of urine the body produces at night. DDAVP is based on research which shows that sufferers of Enuresis have lower than normal levels of something called antidiuretic hormone, which is a hormone that regulates the body’s urine production by having the kidneys hold water so that less urine flows to the bladder.

Children with low levels of this hormone produce more urine nightly. DDAVP corrects this problem by supplying a substance that works in the body just as the hormone does (to reduce urine) and is also though to help children wake more easily.

DDAVP is more likely to work with older children who have normal bladder capacity. Younger children with small bladders are less likely to be helped by the drug.

DDAVP can be taken as a pill or nasal spray. The nasal spray is usually given to younger patients who may have a hard time with the pill form.

However, the spray may be affected by colds or stuffy noses. The pills have also been found to be slightly more effective in some studies.

DDAVP needs to be taken at night but does not need to be taken daily to be effective. This drug also has some side effects, including stomach upset and headache. These symptoms are more common in patients who take the nasal form of the drug. Patients taking the nasal spray may also experience nosebleeds and sinus or nasal pain. More seriously, children who take DDAVP are at risk of seizures caused by water intoxication.

This medical emergency usually has symptoms such as nausea, vomiting and headache. If your child is taking DDAVP and experiences these symptoms, seek medical help right away.

Water intoxication and the risk of seizure can be prevented if children taking DDAVP avoid drinking water the evenings that they are taking the drug. In general, no fluids should be taken in the two hours before retiring and only small amounts in the late afternoon and evening leading up to bedtime.

Imipramine is another drug option.

Imipramine is an anti-depressant which reduces the amount of urine produced during the night. It is sometimes prescribed to children who are unable to take the similarly-working DDAVP, but many doctors are reluctant to prescribe Imipramine because of its many side effects, which can include sleeping problems, nausea, irregular heart beats, and dry mouth.

Some doctors are also quite cautious with this medication because researchers have not been able to completely define how it works to prevent bedwetting.

Imipramine, like most drugs used to treat bedwetting, works best for older children who have normal bladder capacity. Like most other drugs used to treat the problem, it also only affects symptoms, meaning that those who stop taking Imipramine will frequently resume bedwetting.

This drug is usually taken an hour or two before bedtime. Doses vary based on the patient. Side effects with this medication are rare, but may include irritability, sleeping disruptions, fatigue or drowsiness, changes in appetite, mood swings, and personality changes. It is also possible to die from this drug if an overdose occurs.

Anticholinergic drugs are an option for some patients.

Anticholinergic drugs work by increasing bladder capacity and by stopping the contractions of the bladder that some experts think lead to bedwetting. Common Anticholinergic drugs used for bedwetting include oxybutynin (Ditropan) and hyosyamine (Levsinex).

These drugs, unlike many medications used to treat bedwetting, are effective for children with bladder capacity who have trouble controlling their bladders during the daytime as well as at night.

These drugs are usually used with DDAVP for children who wet the bed but may be used alone if a child wets the bed due to general bladder control problems that are present during the day as well. These drugs are taken once or twice a day, often at bedtime. They are not intended for children under twelve years old. Anticholinergic drugs do have a number of side effects, including flushing and dry mouth syndrome.

Be wary of medicating your child if other options are available.

The drugs used to treat bedwetting do not cure the problem, and since these drugs also carry risks and side effects, any parent should think carefully and consider all the risks and options before choosing medication. Medication can be useful for children who wet the bed very late or who seem to suffer unduly from the problem. However, medication should never be treated lightly, nor should it be tried as the first method of stopping bedwetting. You should also remember that children who take medication for bedwetting will often revert to bedwetting once the medication has stopped.

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