Medications for Bed Wetting
Generally speaking, your pediatrician may prescribe medication as a last resort. There is one homeopathic medicine and three types of prescription medicines that are generally used to treat bed wetting. They are:
- Hyland's Homeopathic Bed Wetting Tablets.
- Imipramine (Janimine, Tofranil)
- Desmopressin (DDAVP, Stimate)
- Oxybutynin (Ditropan)
These medications either increase the amount of urine that the bladder can hold (bladder capacity) or decrease the amount of urine released by the kidneys. They are used to temporarily control bed-wetting, not as a treatment to completely stop the condition.
These medications will are ideal for situational use and work well to to control accidental wetting for short periods of time, such as when children are on overnight trips or at camp. In some cases, these medications are used along with other behavioral and conditional therapies to control bed wetting. (see article treatment for bedwetting)
Medications are not usually used with younger children, especially with children under the age of 5 as they may achieve night time control as they get older.Hyland's Bed Wetting Tablets
This Homeopathic bed wetting medication temporarily relieves the symptoms of involuntary urination (common bed wetting) in children.
This medication is ideal for situational use and will work well to to control accidental wetting for short periods of time, such as when children are on overnight trips or at camp.
Imipramine comes in tablet form and is usually taken in the evening. It is not known exactly how imipramine works; it may affect the muscles of the bladder or may cause the child to sleep more lightly or may work the similarly to DDAVP.
Imipramine works best for older children and is most helpful for children who have normal size bladders and who do not have frequent day time wetting. Studies show that about 50% of children treated with imipramine were able to control bed wetting for a short time; and 25% treated with imipramine have long term success.
Imipramine has a number of side effects and if an accidental overdose can result in coma or even death. The use of imipramine is on the decline because other medications like DDAVP have less severe side effects and have proven to be more effective.
DDAVP is available in a nasal spray or in pill form. The medication is a synthetic version of a hormone called vasopressin, also known as antidiuretic hormone. Vasopressin serves many functions, of which one is water regulation and therefore urine production. DDAVP works just like the natural hormone and reduces the amount of urine produced at night to help control night wetting.
Research on DDAVP shows that the dose at which DDAVP is used to eliminate night wetting is safe for most children. The tablets can be used safely for 44 months and the most common side effects are nose bleeds, headaches and stomach aches. While the dose of DDAVP is not generally considered high enough to alter the body salts, many physicians check this once after about three days of starting the medication. This is done with a blood test.
This medication definitely decreases night wetting. DDAVP does not completely eliminate wetting in most children. There is a relapse within 6 months of stopping the medication.
Many studies have shown that DDAVP is effective in stopping night wetting when on the medication and therefore make this an excellent choice for situational use, such as for going over to a friend's house for a sleep over or camping or any other occasion where they may be facing with wetting when not at home.
Oxybutynin (Ditropan) reduce or stop bladder contractions and increase bladder capacity. Anticholinergics may be helpful for children who have daytime wetting due to bladder contractions and/or small bladder capacity. A useful formula for estimating normal bladder volume in children is: age in years + 2 = ounces.
Anticholinergics alone are usually not helpful for children with isolated bed-wetting without any daytime voiding problems. However, some children with bed wetting who fail to respond to DDAVP alone will respond to a combination of DDAVP and an anticholinergic. This is often true for a child who has reduced functional bladder capacity. The reason behind this approach is that the DDAVP reduces night time urine output while the anticholinergic increases nighttime bladder volume. Together, these drugs may prevent bed-wetting by keeping the bladder from becoming full during the night.
For children older than 6 years, the dose of oxybutynin (Ditropan XL) is given once a day to children with daytime wetting symptoms. Another anticholinergic, hyoscamine, is also available in a long acting time capsule. The usual dosage is one hyosyamine twice daily. For children with isolated bed-wetting, only the bedtime dose of oxybutynin or hyosyamine is required. Common side effects are dry mouth and facial flushing. Occasionally, flushing may occur when the child is exposed to hot weather. An overdoes may result in blurring of vision and hallucinations. Fewer side effects have been reported with a newer anticholinergic, tolterodine (Detrol), which is more specific for its action on the bladder. However, this drug is not yet approved for use in children under twelve years.