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Enuresis and Desmopressin (DDAVP)

Updated on June 15, 2014

Disclaimer

**Please note that I am NOT a trained professional, nor do I pretend to be one. I am, however, a parent with a child who has been diagnosed with Autism and who, subsequently, has other issues to deal with. Any information given in these articles is strictly informational in nature; therefore, should NOT be considered as a viable substitute for the expertise, knowledge, skill and/or judgment of a healthcare practitioner.**

To begin with...

In order to understand the mechanisms of Desmopressin, one must first understand the condition in which it is widely used for...Enuresis, or the inability to control urine, either diurnally (during the day) or nocturnally (during the night) or both. Alana, my daughter, has issues with nocturnal Enuresis; in fact, her pull ups for the night are still an expense for us each month. The Desmopressin was tried for a time to help keep the night time bedwetting under control; but, no matter how high her doctor took the nightly dosage, it just did not help like it should have. We have tried incentives, rewards, having her empty her bladder before bed several times, waking her up in the middle of the night; all to no avail.

Causes?

There is a mixture of causes when it comes to who has or doesn't have Enuresis.

  • A child might be born with a predisposition to a slower physical development. In such cases, the urges he or she feels for using the toilet might not be "felt" until much later than another child who might have such predispositions. For example, my oldest daughter, who is now 24, was completely diurnally and nocturnally trained by the age of 18 months; versus Alana, who is now seven and still has issues with night time bedwetting.
  • Some individuals have an overproduction of urine during the night hours. I can see where this might be an issue for Alana. She, just recently, had a procedure to dilate her urethra. Also, Alana drinks a lot of water, thereby causing her bladder to produce more urine.
  • A child may lack the ability to recognize the urges that tell him or her he or she needs to use the toilet. Again, Alana may have this problem. She will sometimes not be able to recognize her need to "potty" during the day hours even because her attention is also on "this, that or the other".
  • Then again, perhaps the child has a high level of anxiety, and, then, due to night time phobias, ends up having issues with night time bed wetting. One of Alana's conditions are anxiety based; therefore, she has a fear of the dark and oftentimes does not like to get out of bed. We always have several lights on in various rooms during the night time hours.


Statistically Speaking

1.) 15%-20% of five year old are diagnosed as having Enuresis, this number can be as high as 40%.

2.) The prevalence for Enuresis changes with age...

  • for five year olds, the prevalence could be as much as 33%
  • for seven year olds, the percentage drops to around 25%
  • for nine year olds, it decreases even more to approximately 15%
  • for 11 year olds, it drops again to roughly 8%
  • for 13 year olds, the next decrease is perhaps 4%
  • for those who are 15-17, it can be as much as 3%

3.) Around 60% of those who have Enuresis are males (again this predisposition to the condition depends on the age of the individual)

  • Up to four to six years of age, the variance between males and females with Enuresis is more equal.
  • By the time an individual reaches age 11, boys are twice as likely to have Enuresis than girls.

Please note...

...Enuresis is only a diagnosis used for an individual who is old enough to be expected to exercise such control with their bladders and urine functions. Naturally, a child who is two years old and who is still learning to "potty" train cannot be said to have Enuresis. On the flip side of a coin, a child who is six, or even seven, can be termed as having Enuresis because said child can, and should, be aware of his or her bladder functions and urges.

Desmopressin (0.2 mg)

Desmopressin (DDAVP)

Desmopressin is a synthetic replacement for vasopressin; the hormone that reduces the urine production with an individual's bladder system.

This hormone can be taken nasally, intravenously or as an oral or sublingual (under the tongue) pill. Alana took an oral pill each night. At one point, she was up to three such pills a night, and still there was no improvement.

Side Effects (Common and Serious)

Some common side effects (that may go away during treatment) include; but, are not limited to:

  • delusions
  • dementia
  • diarrhea

Some serious side effects (those requiring immediate medical attention) include; but, are not limited to:

  • confusion
  • convulsions
  • fast or irregular heartbeat

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