What is the role of imipramine in the treatment of enuresis?

Imipramine is a tricyclic antidepressant that has been historically used for the treatment of enuresis, especially in cases where other behavioral interventions have failed. It is important to note that while it can be effective, its use is considered a second-line option and is typically associated with a higher relapse rate once treatment is discontinued. This means that while it may help reduce episodes of bedwetting during the course of treatment, children may often return to their previous level of enuresis after stopping the medication.

In the context of enuresis, it is primarily effective in older children who have previously been dry for a period. The concerns with its use, particularly regarding cardiovascular side effects, age restrictions, and the potential for relapse are central to its application and choice of therapy.

Imipramine is not considered a first-line treatment; other interventions such as behavioral strategies and enuresis alarms are preferred initially. Additionally, it is not primarily indicated for secondary enuresis; it is more commonly used in cases of primary enuresis. It is also not generally recommended for very young children under the age of 5 due to the potential for side effects and the importance of allowing for normal maturation processes in bladder control. Thus,