**Question:** A patient had nocturnal enuresis with depressive symptoms and was started on an antidepressant drug. What is the drug?

**Core Concept:** Nocturnal enuresis (bed-wetting) is the involuntary loss of urine during sleep, usually in children and adolescents. It is often associated with underlying psychiatric disorders, including depression. Antidepressants are medications used to treat depression by modulating the balance of neurotransmitters in the brain.

**Why the Correct Answer is Right:** The correct answer is (D) Tricyclic Antidepressants as they were the first generation of antidepressants and are commonly used to treat both depression and nocturnal enuresis. Tricyclic antidepressants are known to increase the levels of serotonin, norepinephrine, and/or dopamine in the brain, which helps in the treatment of both depression and nocturnal enuresis.

**Why Each Wrong Option is Incorrect:**

**A.** Selective Serotonin Reuptake Inhibitors (SSRIs): These are second-generation antidepressants that primarily work by inhibiting the reuptake of serotonin, not addressing the issue of nocturnal enuresis.

**B.** Monoamine Oxidase Inhibitors (MAOIs): These are another class of antidepressants that work by inhibiting the enzyme monoamine oxidase, but they are not specifically used for treating nocturnal enuresis.

**C.** Anticholinergics: These are drugs that block the action of acetylcholine, usually used for bladder control issues related to neurological disorders, not for treating nocturnal enuresis.

**Clinical Pearl:**

The correct diagnosis and treatment of nocturnal enuresis should involve a thorough evaluation of the patient's history, including the presence of depression or other psychiatric issues. In such cases, tricyclic antidepressants are the appropriate choice. In non-psychiatric cases, anticholinergics are the appropriate treatment.

In conclusion, the correct answer (D) Tricyclic Antidepressants are used to treat both depression and nocturnal enuresis in patients with psychiatric comorbidities.