Limited evidence for benefits of tricyclics for nocturnal enuresis

Tricyclics and related drugs (grouped together here as tricyclics) were more effective than placebo or no treatment, particularly for short-term responses (14 consecutive dry nights). The tricyclics imipramine, amitriptyline and desipramine were more effective than placebo, but there was no difference for nortriptyline and mianserin. Most tricyclics did not have a sustained effect, and participants relapsed at follow-up after cessation of treatment. There was limited, very low-quality evidence that combining tricyclics with other therapies, such as anticholinergics, might be effective. Reported adverse events were usually of minor consequences, but some trials did not give details of the nature or severity of the side effects. Alarm therapy was superior to tricyclics, with significantly more children achieving 14 consecutive dry nights. Alarm therapy also had a more sustained response, with 42% dry after cessation of treatment, compared with none after cessation of imipramine.