Urinary Incontinence What Drugs Work to Treat Loss of Bladder Contro
Urinary Incontinence - What Drugs Work to Treat Loss of Bladder Contro...
Peter Dazeley/Getty Images Do you have an overactive bladder? The drugs you're taking could be making it worse. There are many types of urinary incontinence, the most prevalent being "" — an urge to urinate so sudden and strong that you often can't get to a bathroom in time. When this type of incontinence has no identifiable cause, it's called "overactive bladder." The drugs typically used to treat this condition include darifenacin (Enablex), fesoterodine (Toviaz); oxybutynin (Ditropan), solifenacin (Vesicare), tolterodine (Detrol) and trospium (Sanctura). These are all anticholinergics — drugs that block the effects of acetylcholine, a neurotransmitter associated with muscle activation, learning and memory.
I'm sorry to say, however, that your aunt long ago reached the age where anticholinergic drugs should almost certainly be ruled out as a treatment option. In older patients, anticholinergics — like the two your aunt has been prescribed — can cause a wide range of adverse effects, including constipation (which, in turn, can cause urinary incontinence), blurred vision, and short-term memory problems, dizziness, , and . When considering how to treat urinary incontinence it's important to remember two things. First, while the muscles in the bladder and urethra lose some of their strength as we get older (and the bladder also loses some of its capacity), incontinence isn't "normal" at any age. Second, urinary incontinence is a symptom, not a disease. Urge incontinence, for example, may be caused by: bladder irritants, including coffee, tea, carbonated drinks, alcohol, and many other foods and beverages overhydration, especially before bedtime constipation and other bowel problems or disease nervous system injuries (such as ) nervous system damage associated with some diseases, such as multiple sclerosis
Further, many commonly prescribed drugs can also cause incontinence or make it worse. Among them: heart medications blood-pressure medications (amlodipine, furosemide, hydrochlorothiazide, lisinopril and torsemide, for example) antidepressants muscle relaxants diuretics sleeping pills I'd recommend that you work closely with your aunt's physician or other health care provider to determine, if at all possible, what might be causing her incontinence. Smoking or being overweight can be contributing factors, for example. While it's not always possible to pinpoint a cause — especially with very old patients — I find that adjusting a patient's medications often resolves or, at least, substantially lessens the problem. Some simple behavioral techniques — including bladder training and scheduled toilet trips — can help, too. If these approaches don't work out, I'd recommend that your aunt try adult diapers, pads or panty liners, which can be purchased just about anywhere. They can be worn comfortably (and invisibly) under everyday clothing and virtually eliminate any risk of embarrassing accidents. In my experience, many patients are reluctant to try this approach, but once over the initial hurdle, come to prefer it for security and peace of mind.
"Ask the Pharmacist" is written by Armon B. Neel Jr., PharmD, CGP, in collaboration with journalist Bill Hogan. They are coauthors of Are Your Prescriptions Killing You?, published by Atria Books. Also of interest: Remember to go to the every day for great deals and for tips on keeping healthy and sharp. Cancel You are leaving AARP.org and going to the website of our trusted provider. The provider’s terms, conditions and policies apply. Please return to AARP.org to learn more about other benefits. Your email address is now confirmed. You'll start receiving the latest news, benefits, events, and programs related to AARP's mission to empower people to choose how they live as they age. You can also by updating your account at anytime. You will be asked to register or log in. Cancel Offer Details Disclosures
What Drug Works for Urinary Incontinence
There' s no easy answer because treatments must be individualized especially with older patients
Q. I take care of my 85-year-old aunt, who has . She had been taking , but it didn't seem to help her, so her doctor prescribed Enablex. The drug made her urinate so often and gave her such horrible nightmares, though, that she got no sleep at all. Now he's put her back on the Ditropan. Is there another medication you have had success with that I could ask the doctor about? A. Urinary incontinence — the loss of bladder control — is a common condition, especially among women and older adults.Peter Dazeley/Getty Images Do you have an overactive bladder? The drugs you're taking could be making it worse. There are many types of urinary incontinence, the most prevalent being "" — an urge to urinate so sudden and strong that you often can't get to a bathroom in time. When this type of incontinence has no identifiable cause, it's called "overactive bladder." The drugs typically used to treat this condition include darifenacin (Enablex), fesoterodine (Toviaz); oxybutynin (Ditropan), solifenacin (Vesicare), tolterodine (Detrol) and trospium (Sanctura). These are all anticholinergics — drugs that block the effects of acetylcholine, a neurotransmitter associated with muscle activation, learning and memory.
More on Drug Side Effects
Savings, resources and news for your well being.I'm sorry to say, however, that your aunt long ago reached the age where anticholinergic drugs should almost certainly be ruled out as a treatment option. In older patients, anticholinergics — like the two your aunt has been prescribed — can cause a wide range of adverse effects, including constipation (which, in turn, can cause urinary incontinence), blurred vision, and short-term memory problems, dizziness, , and . When considering how to treat urinary incontinence it's important to remember two things. First, while the muscles in the bladder and urethra lose some of their strength as we get older (and the bladder also loses some of its capacity), incontinence isn't "normal" at any age. Second, urinary incontinence is a symptom, not a disease. Urge incontinence, for example, may be caused by: bladder irritants, including coffee, tea, carbonated drinks, alcohol, and many other foods and beverages overhydration, especially before bedtime constipation and other bowel problems or disease nervous system injuries (such as ) nervous system damage associated with some diseases, such as multiple sclerosis
Ask the Pharmacist
Information contained in the Ask the Pharmacist column by Dr. Armon B. Neel Jr. is intended to help individuals and their families become more informed about medication usage and interactions, and be better health care consumers. Any advice or information provided should not be followed in lieu of a personal consultation with a trained medical professional.Further, many commonly prescribed drugs can also cause incontinence or make it worse. Among them: heart medications blood-pressure medications (amlodipine, furosemide, hydrochlorothiazide, lisinopril and torsemide, for example) antidepressants muscle relaxants diuretics sleeping pills I'd recommend that you work closely with your aunt's physician or other health care provider to determine, if at all possible, what might be causing her incontinence. Smoking or being overweight can be contributing factors, for example. While it's not always possible to pinpoint a cause — especially with very old patients — I find that adjusting a patient's medications often resolves or, at least, substantially lessens the problem. Some simple behavioral techniques — including bladder training and scheduled toilet trips — can help, too. If these approaches don't work out, I'd recommend that your aunt try adult diapers, pads or panty liners, which can be purchased just about anywhere. They can be worn comfortably (and invisibly) under everyday clothing and virtually eliminate any risk of embarrassing accidents. In my experience, many patients are reluctant to try this approach, but once over the initial hurdle, come to prefer it for security and peace of mind.
"Ask the Pharmacist" is written by Armon B. Neel Jr., PharmD, CGP, in collaboration with journalist Bill Hogan. They are coauthors of Are Your Prescriptions Killing You?, published by Atria Books. Also of interest: Remember to go to the every day for great deals and for tips on keeping healthy and sharp. Cancel You are leaving AARP.org and going to the website of our trusted provider. The provider’s terms, conditions and policies apply. Please return to AARP.org to learn more about other benefits. Your email address is now confirmed. You'll start receiving the latest news, benefits, events, and programs related to AARP's mission to empower people to choose how they live as they age. You can also by updating your account at anytime. You will be asked to register or log in. Cancel Offer Details Disclosures