Medication-Induced Nocturnal Enuresis

Mechanism and Clinical Implications

• Clonidine's central alpha-2 agonist activity can suppress sympathetic nervous system outflow, potentially leading to enuresis, and its effects on sleep architecture might impact arousal to bladder signals 1, 2
• The American Urological Association suggests that limiting evening fluid intake without causing dehydration can help manage medication-induced enuresis 3

Management and Prevention

• Establishing baseline continence status before starting medication and directly asking patients or caregivers about bedwetting during follow-up visits can help monitor and prevent enuresis 3
• The American Urological Association recommends considering the impact of enuresis on quality of life and medication adherence, especially in children and adolescents 3