Antiepileptic Drugs–Induced Enuresis in Children: An Overview

Abstract

Objective: To evaluate enuresis-induced antiepileptic drugs in children. Data Sources: A PubMed search (1917 to July 2020) was performed using the following keywords and associated medical subject headings: antiepileptic drugs, enuresis, pediatric population, drug-induced enuresis, and epilepsy. Study Selection and Data Extraction: The search was conducted to find the role of antiepileptic drugs–induced enuresis in children in studies published in English. Data Synthesis: Enuresis or bedwetting is an underreported adverse drug reaction of antiepileptic drugs. Owing to that fact, it is a condition that is outgrown with age and also could cause embarrassment. As antiepileptic drugs sometimes need to be taken for a long duration until epilepsy relapses, the occurrence of enuresis in this situation can be troublesome for both the child and the caretaker. Even though enuresis is proposed to have a significant effect on the child’s psychology, it is still considered to be a condition that is outgrown with age. This article includes a review of antiepileptic drugs reported to have caused enuresis in children. Conclusions: If a child develops enuresis as an adverse drug reaction, this adds further challenges to their life. A better understanding of this potential adverse effect may help prevent unwanted stress. Though the exact mechanisms are not known, the hypothesis generated is from the occurred cases, most of which relapsed when the drug was withdrawn. Considering the gravity of epilepsy in children, more detailed studies need to be conducted on this adverse effect to ensure a safe and effective treatment in children.

Levetiracetam-Induced Urination and Urinary Frequency in Pediatrics. A Case Report

“…6 Prolonged carbamazepine therapy caused urinary overflow incontinence, as reported by Andres et al 7 A 36 years old male diagnosed with schizophrenia and put on topiramate who developed urinary incontinence while asleep and subsided when topiramate was discontinued and replaced by another drug. 8 The pathway responsible for incontinence varies, while it is thought it could be related to the depth of sleep as in valproate-induced enuresis, 9 and over-relaxation to striatal muscle in benzodiazepine and gabapentine. 9,10 Although levetiracetam was suggested by its psychiatric effect, 5 the mechanism by which LEV can cause urinary frequency is not fully understood, and further evaluation is needed.…”

“…8 The pathway responsible for incontinence varies, while it is thought it could be related to the depth of sleep as in valproate-induced enuresis, 9 and over-relaxation to striatal muscle in benzodiazepine and gabapentine. 9,10 Although levetiracetam was suggested by its psychiatric effect, 5 the mechanism by which LEV can cause urinary frequency is not fully understood, and further evaluation is needed. Renal function tests could be affected in the case of urinary incontinence; however, it was normal in our patients.…”

Sodium valproate-induced nocturnal enuresis in epilepsy: Three case reports and a review of the literature

“…Sodium valproate (VPA) is an effective drug in the treatment of epilepsy in adults and children, as well as migraine, bipolar disorder, and trigeminal neuralgia ( 1 ). As a kind of GABAergic agonist, VPA enhances GABAergic activity in the brain, which subsequently controls seizures ( 2 , 3 ). Most side effects of VPA are mild and transient, including vomiting, nausea, abdominal pain, headache, tremor, and drowsiness ( 3 , 4 ).…”

“…As a kind of GABAergic agonist, VPA enhances GABAergic activity in the brain, which subsequently controls seizures ( 2 , 3 ). Most side effects of VPA are mild and transient, including vomiting, nausea, abdominal pain, headache, tremor, and drowsiness ( 3 , 4 ). However, several adverse events induced by VPA, such as amnesia, hair loss, increased body weight, pancreatitis, hyperammonemia in the blood, and nocturnal enuresis, are comparatively infrequent and recognized by clinicians, which may be detrimental to treatment adherence ( 4 – 7 ).…”