There are at least 5-7 million children who have problems with bed wetting. This social problem is quite difficult to treat. Over the years many types of non-medical and medical treatments have been approved for enuresis. One should understand first that there is no medication that is 100% effective or can cure enuresis. All medications currently used to treat enuresis only work for a short time and many have potent side effects.
Medications are not first line of therapy for bed wetting. In most cases medications are only started after behavior therapy and alarms have failed. Among the drugs, imipramine (tofranil) is often used to treat both children and adults with enuresis. The drug goes by several names including Imiprex, tofranil and Sermonil.
Imipramine is a good drug for the treatment of depression, various pain syndromes, insomnia and neuropathy. Tofranil has been used to treat enuresis for more than 3 decades. The lowest dosage of Tofranil is usually administered and the response to bed wetting is observed. Most people begin to see a response in a few days. The dose is usually increased if no response is seen after 2 weeks. The initial success rates of tofranil are low. Only 10%-20% of children and about 25% of adults respond to this therapy. However, for some unknown reason with continued long-term treatment, its effectiveness disappears. The exact manner in which Tofranil controls bed wetting is unknown but its action are thought to be related to its anti-cholinergic activity and potentiation of the sympathetic system. The dose of imipramine is based on the body weight.
The drug is also given to adult patients with bed wetting but only if there is no evidence of any heart problems like congestive heart failure, history of palpitation or strokes. Because the drug can lower seizure threshold, it is usually not given to patients with such a history.
Tofranil is available as tablets of 10 mg, 25 mg and 50 mg. In most cases the children are treated for 3-6 months and then the drug is weaned slowly by decreasing the dosage every few weeks. Relapses are quite common when the drug is discontinued. Even though tofranil is widely prescribed with modest results, it frequently has to be discontinued because of persistent side effects.
Side effects of Tofranil include:
* fast heart rate
* blurred vision
* dry mouth
* constipation
* weight gain
* low blood pressure
Tofranil has also been associated with accidental overdose and thus, precaution is required during dispensing this medication to children.
For more on bedwetting supplies, please visit www.medexsupply.com
Showing posts with label bedwetting. Show all posts
Showing posts with label bedwetting. Show all posts
Wednesday, February 25, 2009
Tuesday, February 17, 2009
Bed Wetting and DDVAP (Desmopressin)
Bedwetting is not a life threatening disorder but can create havoc in the life of an individual. In most cases, children who have a bed wetting problem grow out of it with time. Some children may improve with the use of an enuresis alarm. However, in other cases, the problem of bed wetting can be severe and may warrant medications. One of the best medications to treat bed wetting today is DDAVP or desmopressin. DDAVP is actually a synthetic hormone and is very effective in the treatment of enuresis.
DDAVP is available both as a pill and as a nasal spray. It works by reducing the amount of urine produced at night. With less urine formed, the bladder remains less full and the urge to urinate disappears. DDAVP is generally used in children after all conservative approaches have been tried and failed.
DDVAP is obtainable as a nasal spray but it is currently under FDA restriction and not recommended for use in the treatment of primary enuresis.
DDAVP pill is usually taken at the lowest dose just before bed time. The dose is gradually increased every 3-4 days until the desired response is obtained. The oral pill is placed underneath the tongue where it usually dissolves very fast. One should not take the pill with a glass of water. Water should be limited at night as one is trying to prevent excess urine formation.
The side effects of DDAVP include nose bleeds, headaches and abdominal bloating. These side effects are not common but do occur in about 1-3% of children.
DDAVP is very effective in stopping night time bed wetting and is an excellent choice when one is going for a trip or to sleep over at friend’s house.
Most parents report that DDAVP immediately decreases enuresis in their child. The drug only decreases the frequency of bed wetting but does not cure the problem. Most health care professionals recommend that after a period of 1-2 months, the dose of DDAVP should be slowly decreased. However, most data indicate that relapse of enuresis is quite common when the drug is stopped or the dosage is decreased. This cycle of re-starting and tapering DDAVP usually goes on for months, before one can finally stop the drug.
Unfortunately, in some children DDAVP is used to control bed wetting for many months. In such cases, a few parents tolerate some degree of bed wetting and stop the drug cold turkey.
To ensure that DDAVP works, it is important not to give the child any fluids before bedtime. Current data indicate that DDAVP works in about 80% of children with primary enuresis.
DDAVP is available both as a pill and as a nasal spray. It works by reducing the amount of urine produced at night. With less urine formed, the bladder remains less full and the urge to urinate disappears. DDAVP is generally used in children after all conservative approaches have been tried and failed.
DDVAP is obtainable as a nasal spray but it is currently under FDA restriction and not recommended for use in the treatment of primary enuresis.
DDAVP pill is usually taken at the lowest dose just before bed time. The dose is gradually increased every 3-4 days until the desired response is obtained. The oral pill is placed underneath the tongue where it usually dissolves very fast. One should not take the pill with a glass of water. Water should be limited at night as one is trying to prevent excess urine formation.
The side effects of DDAVP include nose bleeds, headaches and abdominal bloating. These side effects are not common but do occur in about 1-3% of children.
DDAVP is very effective in stopping night time bed wetting and is an excellent choice when one is going for a trip or to sleep over at friend’s house.
Most parents report that DDAVP immediately decreases enuresis in their child. The drug only decreases the frequency of bed wetting but does not cure the problem. Most health care professionals recommend that after a period of 1-2 months, the dose of DDAVP should be slowly decreased. However, most data indicate that relapse of enuresis is quite common when the drug is stopped or the dosage is decreased. This cycle of re-starting and tapering DDAVP usually goes on for months, before one can finally stop the drug.
Unfortunately, in some children DDAVP is used to control bed wetting for many months. In such cases, a few parents tolerate some degree of bed wetting and stop the drug cold turkey.
To ensure that DDAVP works, it is important not to give the child any fluids before bedtime. Current data indicate that DDAVP works in about 80% of children with primary enuresis.
Monday, February 16, 2009
Bed Wetting in Adults Part 1
There are at least 2-4 percent of adults who involuntary void urine during sleep. Nocturnal enuresis (Bedwetting) is the unintentional urination that occurs at night. Nocturnal bed wetting in adults is generally classified into two categories- primary and secondary.
With primary nocturnal bed wetting, the condition most likely starts in childhood and progresses into adulthood. In these individuals, nocturnal enuresis is not a daily occurence but occurs at least 1-4 times every few months.
The exact number of adults who have this problem is not known because most people do not brag about it nor do they tell their health care worker about it. The secondary onset bed wetting almost always starts off at an older age; the individual may have had no problem in childhood but suddenly the bed wetting starts in adulthood. In some cases, the child may have bed wetting and achieved bladder control but relapses later in adulthood.
Bed wetting is not a recent problem in humans; it has been reported in the archives as early as 1500 BC. Although much is known about bed wetting in the child, the problem has been less studied in the adult.
With primary nocturnal bed wetting, the condition most likely starts in childhood and progresses into adulthood. In these individuals, nocturnal enuresis is not a daily occurence but occurs at least 1-4 times every few months.
The exact number of adults who have this problem is not known because most people do not brag about it nor do they tell their health care worker about it. The secondary onset bed wetting almost always starts off at an older age; the individual may have had no problem in childhood but suddenly the bed wetting starts in adulthood. In some cases, the child may have bed wetting and achieved bladder control but relapses later in adulthood.
Bed wetting is not a recent problem in humans; it has been reported in the archives as early as 1500 BC. Although much is known about bed wetting in the child, the problem has been less studied in the adult.
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