Q. My daughter still wets the bed at age six. She has been seen by a urologist who didn’t find anything wrong. Needless to say, she is extremely embarrassed about this situation. She can’t sleep over at a friend’s house and it’s awkward to explain why.
She has been taking Ritalin for ADD this year. It has helped her concentration, but I don’t know if it contributes to the bed-wetting. Our doctor recently prescribed imipramine to see if it would solve that problem. It seemed to help for a few days. I stopped giving it to her, however, because it seemed to make her irritable. I worry that taking both drugs every day might have lasting effects on her. Is there an approach that minimizes medications?
A. When Ritalin (methylphenidate) and the antidepressant imipramine are taken together, blood levels of imipramine may be higher than expected. This could lead to side effects such as insomnia, nervousness, digestive upset and irritability.
Sleep expert Martin Scharf, Ph.D., suggests reducing snacks and drinks (especially caffeinated soft drinks) in the evening. He also recommends bladder stretching exercises by asking the child to delay urinating during the day for gradually increasing periods. Your daughter should go to the bathroom just before bedtime and then you should wake her an hour later to pee again.
A wetness alarm (DRI Sleeper, Nature Calls, Wet-No-More) that sounds a tone at the first hint of urine can be helpful. She should be rewarded for each dry night. Be patient, as it may take several months to see improvement.
