**Core Concept**
Nocturnal enuresis, or bedwetting in children, is often treated with antidepressants that act as anticholinergics and inhibit acetylcholine-mediated bladder filling. Imipramine, a tricyclic antidepressant (TCA), has anticholinergic properties that reduce bladder overactivity and increase bladder capacity.

**Why the Correct Answer is Right**
Imipramine is the most effective antidepressant for nocturnal enuresis due to its strong anticholinergic effects, which reduce bladder contractions and improve bladder capacity. It works by blocking muscarinic receptors in the bladder, decreasing detrusor muscle activity. Clinical studies show significant improvement in dryness rates, especially in cases with a strong neurogenic component. Its use is well-established in pediatric urology and psychiatry for this indication.

**Why Each Wrong Option is Incorrect**
Option B: Fluoxetine is a selective serotonin reuptake inhibitor (SSRI) with minimal effect on bladder function and is not indicated for nocturnal enuresis.
Option C: Trazodone is used for insomnia and has weak anticholinergic effects; it is not effective or approved for enuresis.
Option D: Sertraline, another SSRI, lacks anticholinergic action and is not used in enuresis treatment.

**Clinical Pearl / High-Yield Fact**
Imipramine remains the first-line antidepressant for nocturnal enuresis in children, especially when behavioral therapies fail. Its anticholinergic action directly targets bladder overactivity, making it uniquely effective among antidepressants.

✓ Correct Answer: A. Imipramine