Cochrane Summaries

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Tricyclic drugs for bedwetting in children

Glazener CMA, Evans JHC, Peto RE
Published Online: 
21 January 2009

Night-time bedwetting is common in childhood, and can cause stigma, stress and inconvenience. The review examined 58 trials of tricyclic drugs which included 3721 children. Tricyclics are antidepressants, but probably work because of one of their side effects (affecting the messages sent to the bladder by the nerves). The one most commonly used is imipramine, which can be used for up to three months. Tricyclic drugs reduce bedwetting by about one wet night per week while being used and about a fifth of the children become dry. However, they do not work once the children stop using them. Compared with the other commonly used drug, desmopressin, tricyclics are less expensive but have more side-effects. A particular concern is tricyclic overdose, which can be serious. Bed alarms are more expensive than tricyclics and more bother to families to use but about half the children remain dry after alarm treatment has finished, and they do not have the side-effects of the drugs.