What class of drugs is typically used as the second-line treatment for enuresis?

The second-line treatment for enuresis, particularly nocturnal enuresis, often involves the use of tricyclic antidepressants (TCAs). One common TCA used for this purpose is imipramine. TCAs can help reduce the frequency of enuresis by affecting neurotransmitter levels that influence bladder function and the child’s ability to wake up when the bladder is full.

While other classes of medications may be considered in different contexts, TCAs have a specific mechanism that allows them to address the underlying pathophysiology associated with enuresis. They are effective in enhancing bladder capacity and reducing the likelihood of bedwetting episodes. Additionally, a significant consideration in their use is that TCAs can also have a sedative effect, which, in some children, may promote better sleep continuity and reduce enuresis events.

In comparison, antihistamines are primarily used to treat allergy symptoms and do not have the appropriate action on bladder control, benzodiazepines are generally used for anxiety or as sedatives and are not indicated for enuresis management, and SSRIs, while useful for certain anxiety disorders, do not have a specific role in treating enuresis. Therefore, TCAs are distinctively recognized as a second-line