There are two very common drugs that are used, one is called desmopressin and the other is
called oxybutynin. Desmopressin acts like the anti diuretic hormone I've mentioned in
the past. The whole idea of this drug is to try and reduce the amount of urine that the
kidneys are producing overnight and it can be taken either as a tablet or slipped under
the tongue as a little melt just before going to bed. It’s started at a low dose and if
there’s no benefit after a few weeks then the dose can be increased to see if that helps.
In general desmopressin is a very safe drug to take, it doesn't cause very many side effects.
But like all medications there's a very small number of young people who may complain of
some nausea, vomiting or loss of concentration amongst other things whenever they're taking
the desmopressin. If you're worried about any new signs or symptoms that develop after
your young person starts taking it you should just have a chat to your family doctor about
it. If the young person who's taking desmopressin starts to have any vomiting or diarrhoea it's
important that you don't give the desmopressin during this period of time because that can
cause problems with the fluid in the body and problems with the salts in the body.
Oxybutynin is another very common medication that's used to try and help young people with
bedwetting and oxybutynin acts like a relaxant for the bladder, it chills the bladder out.
It's mainly used to try and treat the overactive bladder that we see a lot in young people
and if that's present at night that can cause the bladder to squeeze down and make the young
person wet the bed and again it can be started at a low dose and the dose increased if there's
no benefit to it. Again it can cause problems such as nausea, vomiting, loss of concentration,
change of mood. And again if you're worried about any new symptoms that develop after
your young person starts to take oxybutynin then it's worthwhile having a chat to your
family doctor about this.
Bedwetting is such a common problem in young people that NICE (the National Institute for
Health and Care Excellence) have developed a guideline which should be used nationally,
so it doesn't matter if you go to see your family doctor in London or somebody in the
north of the country, they should be able to follow these guidelines. NICE suggest that
you can try either the desmopressin or the oxybutynin as the first line treatment. If
the drug that you're given doesn't work you should then try the other drug, so if you've
tried desmopressin and that hasn't worked then you should try oxybutynin and vice versa
and if you find that desmopressin and oxybutinin on their own have both failed, then the next
step is a trial of both drugs together. If desmopressin and oxybutynin together don't
work then there is another drug called imipramine that can be used to try and help bedwetting.
But by the time that you're getting onto using imipramine it doesn't have a high success
rate, but it does work in some young people and if you warrant trying imipramine, your
doctor will discuss this with you.