: Medication may be helpful in certain children
that bed-wet
DEAR DR.PAUL: My daughter is 10 years old. She has been
an on-again-off-again bedwetter. What is your opinion on DDAVP
(desmopressin)? I would love for my daughter to have 100% dry
nights. Could taking DDAVP make this come true?
PEDIATRICIAN DR.PAUL Answers: Your wish is shared by
all parents who have children who wet the bed.
The good news is that most children outgrow this problem. However,
in the interim, we must keep in mind the psychological effect
of the bedwetting on children.
In general, most parents are willing to wait it out or use simple
behavior/reward systems for the problem. Some even use an enuresis
alarm, but most do not feel the problem is severe enough to
warrant medications.
For the most part I agree with this approach, as long as the
child's self esteem is not affected. However, in older children,
especially adolescents, bedwetting can be a great source of
embarrassment and stress. An adolescent who wets the bed will
not want to partake in sleepovers or go to camp with friends.
Additionally, they are always worried their friends will find
out about "their problem".
Under these circumstances, I often discuss using medication
to help control the bedwetting. Up until about 10 years ago,
the medication available for bedwetting was actually an anti-depressant
that worked by preventing the bladder from emptying at night.
Personally, I was uncomfortable giving this kind of medication
to children. However, I am more comfortable using DDAVP (or
desmopressin). DDAVP is a synthetic hormone that helps the body
retain fluid at night, thereby can prevent bed-wetting. This
medication is quite safe and usually highly effective (up to
75-80%) and if it works, it will work right away.
DDAVP is given at bedtime, either by nasal spray or in tablet
form. The only precaution is not to give children fluids before
going to bed.
Practically speaking, DDAVP can render children dry at night.
So in children in whom DDAVP works, it is ideal for stopping
the bedwetting during certain periods such as sleepovers or
camp. In other cases, where the child's self esteem is really
suffering or the whole family is upset by the bed wetting, DDAVP
can be used to stop the bedwetting for a certain period so that
everybody can get a break.
Once the DDAVP is stopped, the bedwetting may return because
the drug is a treatment, not a cure. However, I want to stress
that most children do eventually outgrow the problem. Still,
it's helpful to know that in the meantime that there are ways
of stopping the bedwetting, at least temporarily. Whether a
bedwetting child needs, or would benefit from DDAVP, depends
on the individual situation. Whether to use the drug, and for
how long, are issues that should be openly discussed with your
doctor and importantly with your pre-teen or adolescent child.
The information provided in this site is
designed to be an educational aid only. It is not intended to
replace the advice and care of your child's physician, nor is
it intended to be used for medical diagnosis or treatment. If
you suspect that your child has a medical condition, always
consult a physician.
