Bedwetting Drug Therapy – Warnings

Drugs Used to Treat Bed Wetting: DDAVP, Ditropan, Tofranil

Untitled_4.jpgOver the years at the Enuresis Treatment Center, we have heard from hundreds of families who have tried bedwetting medication, drug therapy for the treatment of bedwetting. Families express their frustration with this being the foremost advice from doctors, especially when the drugs are often found to be ineffective, or, if effective at all, the bedwetting resumes automatically once the drugs are removed from the childʼs system.
Most disconcerting is the fact that drugs are being put into a childʼs body, especially when it is not effective for treating the underlying cause of bedwetting: The deep sleep disorder. According to the American Academy of Pediatrics, less than 1% of bedwetting is ever caused by a medical problem. Given the alarming new information about the deadly side effects of these drugs, we encourage you to discontinue the use of these drugs immediately.
    • Nasal sprays containing Desmopressin are no longer approved by the FDA to treat bedwetting in children, older children bed wetting and bedwetting in teenagers.

 

    • Desmopressin tablets should not be taken by patients with fluid or electrolyte imbalances. Fever and vigorous exercise can cause these imbalances.

 

  • Since 1975, we have successfully offered a bed wetting solution.  We have treated and ended bedwetting without the use of drugs or invasive surgery.

About Desmopressin

Desmopressin is marketed as DDAVP Nasal Spray, DDAVP Rhinal Tube, Minirin, and Stimate Nasal Spray. Desmopressin is an antidiuretic. It limits the amount of water that’s eliminated in urine. The body needs to balance its levels of water and sodium. Too little sodium or too much water can cause hyponatremia, which can cause seizures and death.

FDA’s Advice for Patients

The FDA provides the following advice for patients (and parents) taking desmopressin:
    • Tell the doctor about all drugs the patient is taking

 

    • Tell the doctor if the patient has a history of hyponatremia

 

  • Supervise the patient’s use of intranasal desmopressin
    • Restrict fluid intake from one hour before to eight hours after taking desmopressin tablets

 

    • Promptly call the doctor if the patient’s water intake changes

 

  • Promptly call the doctor if hyponatremia symptoms occur
Hyponatremia symptoms include nausea, vomiting, fatigue, muscle cramps, and weakness. Those symptoms don’t always mean the patient has hyponatremia, so check with a doctor to be sure.

Desmopressin Use

The FDA has made some changes in its approved uses of desmopressin. Nasal sprays containing desmopressin (intranasal desmopressin) are no longer approved to treat bed-wetting in children.

All desmopressin formulations should be used cautiously in patients taking certain drugs that may cause them to drink more fluids. Those drugs include tricyclic antidepressants and another type of antidepressant called selective serotonin reuptake inhibitors (SSRIs), according to the FDA.

The FDA has asked for those warnings to go on desmopressin’s label. SOURCES: FDA: “Information for Healthcare Professionals: Desmopressin Acetate.” News release, FDA. Reuters.

FDA Warns That Some Patients Taking Desmopressin May Be at Risk of Seizure and Death

By Miranda Hitti WebMD Medical News, Reviewed By Louise Chang, M.D.

Dec. 4, 2007 — The FDA today warned that some patients taking the drug desmopressin, including children who take desmopressin to stop bed-wetting, may be at risk of seizures and death. The FDA notes 61 postmarketing reports of seizures — including two deaths — in patients taking desmopressin.

Those seizures were linked to hyponatremia, an imbalance of sodium levels in the body, according to the FDA. It’s not clear why the patients who had seizures were taking desmopressin, which isn’t just used to treat bed-wetting.

But among the 25 patients younger than 17 who had seizures while taking desmopressin nasal spray (intranasal desmopressin), bed-wetting was the most common reason. Children taking intranasal desmopressin to treat bed-wetting are “particularly susceptible to severe hyponatremia and seizures,” states the FDA.

From Our Expert Barbara Moore, Founder and Director, Enuresis Treatment Center, regarding DDAVP use:

barbara.jpg“Sometimes drugs work temporarily and sometimes they are absolutely no help at all,” says Barbara Moore.

Ms. Moore’s treatment approach focuses on deep-sleep bed wetting caused by an inherited sleep disorder, not a bladder problem. This theory is supported by research, which finds bedwetters are unusually deep sleepers.

“When you’re in the deep sleep, the brain and bladder can’t make the connection to let you know the bladder is full, and then bedwetting occurs,”

So if you’re treating it with drugs, you’re not treating the problem, you’re treating the symptoms.”

Ms. Moore says doctors in the United States prescribe DDAVP far too casually, often setting a patient up for a big disappointment.

“Older children still bed wetting get their hopes up, and then if the drug does not work, it becomes another failure experience for them,” she says.

Even when the drugs are temporarily effective, bedwetting resumes when they stop taking it. Using this as a bedwetting treatment for teenagers “It’s the worst thing because they think the problem is gone, but it’s just putting a Band-Aid over a sore,” Ms. Moore says.

Ditropan Has Been Linked to Hallucinations

On April 9, 2007, the FDA released documents stating the Johnson & Johnsonʼs drug Ditropan for overactive bladders needs stronger warnings about the threat of hallucinations and other related problems in children and older patients. The Food & Drug Administration originally approved Ditropan (generic: Oybutynin) in June 1999.

Tofranil

Tofranil is used to treat depression. It is a member of the family of drugs called tricyclic antidepressants.

Some doctors also prescribe Tofranil to treat bulimia, attention deficit disorder in children, obsessive-compulsive disorder, and panic disorder.

Tofranil-PM, which is usually taken once daily at bedtime, is approved to treat major depression.