Medicine For Bedwetting
- Ditropan and Tofranil
Two other drugs are sometimes prescribed as a medicine for bedwetting. These are Oxybutynin Chloride or Ditropan, and Imipramine or Tofranil.
When my son was six I did give him Tofranil on advice from a doctor for bedwetting. I gave it to him for three days and he was dry each night. That it works is proven. However after the first night my son looked tired and listless and at the end of the second day the dark circles under his eyes were like thunderclouds.
His zombie like behaviour on the third day caused me to have a sleepless night myself worrying about this treatment. I discontinued the Tofranil because I couldn’t convince myself that the bedwetting medicine wasn’t worse than the disorder. After no treatment on the fourth day, he was back to his normal cheeky energetic self by the fifth, with no lasting ill effects.
From my experience, if you need to give a child this medicine, keep it for very important things such as an airline flight or a very long train trip.
Imipramine or Tofranil.
Imipramine Hydrochloride (brand name Tofranil) is a relatively inexpensive trycyclic antidepressant that has been used as a medicine for bedwetting for over 30 years.
The exact way imipramine works to reduce bed-wetting is not known. It may affect the muscles of the bladder reducing contraction like Ditropan, and it may work by causing the child to sleep more lightly. Or it may have an effect on the hormone that causes the kidneys to release urine (called an ADH - antidiuretic hormone ) like Desmopressan.
This medicine for bedwetting, like the others, is most often used in conjunction with another form of bedwetting treatment such as behaviour and motivational therapy.
Tofranil is generally prescribed for children 6 years and older. It works best for older children and children who do not have frequent daytime accidental wetting. Tofranil is most helpful for children who have normal-sized bladders. It also works better for children who have experienced periods of bladder control before starting treatment.
Tofranil is in tablets that are usually taken in the evening. They may also be advised to take it midafternoon and at bedtime, which can help to prevent bedwetting accidents that occur in the first stage of sleep.
Special Concerns about Tofranil
Imipramine Hydrochloride is a prescription medication that requires monitoring by a physician. Some common reactions that have been reported after using Tofranil are nervousness and anxiety, difficulty sleeping or insomnia, gastrointestinal disturbances including constipation, fatigue and sensitivity to sunlight.
Less common side effects include; mood or personality changes including uncontrollable crying, headaches, abdominal pain, decreased appetite, blurred vision.
NB. Parents must be very careful to keep Tofranil out of the reach of children, as this medication can be toxic in large doses. Accidental overdose can cause a very fast heartbeat, seizures, coma, hypotension and it can be fatal.
Oxybutynin Chloride or Ditropan
Oxybutynin Chloride (brand name Ditropan) is an anti-spasmodic or anticholinergic drug and can also be useful for treating daytime wetting.
This works differently from the two previous drugs. Anticholinergic drugs increase the bladder capacity and stop the contractions of the bladder, which is what some experts think leads to bedwetting. Another example is hyosyamine (Levsinex).
Unlike the bedtime drugs, bedwetting medications such as the anticholinergic drugs are effective in children that have trouble controlling in the daytime as well as night. They reduce the frequency of bladder contractions and so they work by delaying the urge to urinate.
These drugs are commonly used with desmopressin for children who wet the bed but may be used alone if a child wets the bed due to general bladder control troubles that are present during the day as well.
Ditropan has been used for many years by pediatric and general urologists for bladder spasms. This medicine for bedwetting has the ability to relax the bladder during sudden and frequent urges to urinate. It is a very effective medicine in people that have urinary frequency (urinating often) and urinary urgency (sudden desires to urinate) during daytime hours.
Although probably not as good as desmopressin and imipramine for nocturnal enuresis, oxybutynin has been used for bedwetting with some success.
It is not known exactly how it works, but it’s thought that it may have three actions. It can relax the bladder. It may work by decreasing the depth of sleep in the last third of the night. This action may allow a child more time to wake up when the bladder gets full and thereby avoid any wet bed accidents. It may increase the bladder capacity or size during sleep, especially if taken one hour before bedtime.
Special Concerns about Ditropan
Oxybutynin Chloride is a prescription medication that requires monitoring by a physician. It is taken once or twice a day, most often at bedtime and is not intended for children under twelve years old.
Some reactions that have been reported after using Ditropan include drowsiness, dry mouth and constipation, facial flushing, and sometimes hallucinations. Overall, it is considered to be a safe medication.
Fluoxetine or Clonidine and Bedwetting
Although I have been asked about fluoxetine and clonidine for bedwetting as regards their efficacy as medications for bedwetting, I failed to find any documentation of their use for child bedwetting or enuresis.