Thursday, 23 June 2011

What bladder drug are you on?

van Rey and Heesakkers. Solifenacin in multiple sclerosis patients with overactive bladder: a prospective study. Adv Urol. 2011;2011:834753. Epub 2011 May 5.

This study assessed the efficacy and the effect on Qol of solifenacin (Vesicare) for overactive bladders in MS'ers. Solifenacin resulted in a significant decrease in number of micturitions and number of continence pads used per day compared to baseline. The severity of urinary urgency prior to passing urine decreased significantly and there was an increase in the volume of urine passed. Two thirds of MS'ers chose to continue solifenacin therapy after completion of the study. The majority of MS'ers reported an improvement in their QoL.

"Is this study important? Yes. Bladder problems are one of the curses of having MS; effective treatments are very helpful. Please note another intervention that improves quality of life."

"Solifenacin is one of the new generation drugs that has been designed not to penetrate the brain and to work in the periphery; i.e. on the bladder where its action is needed. Why is this important? One of the most commonly prescribed drugs for overactive bladders is oxybutynin; this drug is an old generation drug that penetrates into the brain and affects cognition. Oxybutynin has been been shown consistently to impact on cognitive function; in a disease such as MS that already affects cognition this is simply a no-no. I personally stopped using oxybutynin over 5 years ago and only prescribe the newer generation agents. If you are an MS'er and are on oxybutynin you should speak to you GP, MS clinical nurse specialist, continence nurse or neurologist about changing you onto a newer drug that are associated with less of this particular side effect; for example tolterodine (Detrusitol), solifenacin (Vesicare) or others."


"I can't stress the importance of symptomatic therapies to improve the QoL of MS'ers. I spend most of time in clinic doing this. This is contrary to what people think; i.e. prescribing and monitoring DMTs."

CoI: Nil

3 comments:

  1. What are your most commonly prescribed symptomatic therapies? Another question - can you say which are your most effective symptomatic therapies? I know these are difficult questions to answer as everyone is so different.

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  2. Re "What are your most commonly prescribed symptomatic therapies?": this is large topic and I will try and cover these therapies over the next few months, by targeting specific problems as new research papers arise. Sorry this doesn't answer your question at the moment.

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  3. I'm on a trial of AIMSPRO for bladder sx in SPMS - currently at the open label stage. I'm really finding it very beneficial. It's only a small trial, so hopefully more work will be done soon and it'll be made available on prescription.

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