Pediatric patient enuresis

Children Not recommended for patients younger than 12 years of age. Safety and efficacy are not established for amoxapine in children younger than 16 years of age or trazodone or clomipramine in children younger than 10 years of age. The safety and efficacy of imipramine as temporary adjunctive therapy for nocturnal enuresis in pediatric patients younger than 6 years of age have not been established. The safety of the drug for long-term, chronic use as adjunctive therapy for nocturnal enuresis in pediatric patients 6 years of age and older has not been established. Safety and efficacy are not established in the pediatric age group for trimipramine, nortriptyline, protriptyline, and desipramine. 

Recognize the signs and symptoms of the major types of urinary incontinence and pediatric enuresis in individual patients. 

List the treatment goals for a patient with urinary incontinence or pediatric enuresis. 

Considering that pharmacotherapy is inferior to select non-pharmacologic treatment modalities in pediatric enuresis, pharmacotherapy will be most valuable in patients who are not candidates for nonpharmacologic therapy due to nonadherence or who do not achieve the desired outcomes on nonpharmacologic therapy alone. 

Robson WL, Norgaard JP, Leung AK. Hyponatremia in patients with nocturnal enuresis treated with DDAVP. Eur J Pediatr 1996 155(ll) 959-62. 

Schwab M, Ruder H. Hyponatraemia and cerebral convulsion due to DDAVP administration in patients with enuresis nocturna or urine concentration testing. Eur J Pediatr 1997 156(8) 668. 

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