Anticholinergic agents
Anticholinergic agents have been used for nocturnal enuresis treatment, however, have shown limited efficacy. They help by reducing detrusor muscle contractions, which are more implicated in diurnal enuresis, rather than nocturnal enuresis. These agents only show efficacy, and therefore are only recommended, when the child is experiencing detrusor muscle over-activity. Oxybutynin has a 67% response rate in children with detrusor overactivity. It may be combined with desmopressin if the child is experiencing detrusor overactivity and has excess urine production. 4mg of long-acting tolterodine may also be combined with desmopressin, when desmopressin alone is not sufficient. Side effects can include dry mouth, constipation, dry eyes, dizziness, and somnolence.
References:
Gorodzinsky FP. Genitourinary Disorders: Urinary Incontinence in Children. In: e-Therapeutics+. Ottawa, ON: Canadian Pharmacists Association; 2013. https://www.e-therapeutics.ca/tc.showChapter.action?documentId=c0052. Updated May 2011. Accessed Mar 20, 2013.
Tu ND, Baskin LS. Management of nocturnal enuresis in children. In: Basow DS, ed. UpToDate. Waltham, MA: UpToDate; 2013. www.uptodate.com. Updated Dec 4, 2012. Accessed Mar 18, 2013.
Gorodzinsky FP. Genitourinary Disorders: Urinary Incontinence in Children. In: e-Therapeutics+. Ottawa, ON: Canadian Pharmacists Association; 2013. https://www.e-therapeutics.ca/tc.showChapter.action?documentId=c0052. Updated May 2011. Accessed Mar 20, 2013.
Tu ND, Baskin LS. Management of nocturnal enuresis in children. In: Basow DS, ed. UpToDate. Waltham, MA: UpToDate; 2013. www.uptodate.com. Updated Dec 4, 2012. Accessed Mar 18, 2013.