Best Medications for Overactive Bladder
Having overactive bladder, or OAB, can be embarrassing, uncomfortable, and even painful. OAB is a set of symptoms that includes a frequent need to urinate, sudden urges to urinate, the inability to control urination, the need to urinate more than once overnight, leakage, and urge incontinence.
If you have OAB, you may experience one or more of these symptoms and it may cause interference with your daily life. The good news is that there are treatment options for OAB, including effective medications.
Treatment for OAB
Medications cannot cure OAB, and they can cause side effects, so trying alternatives first is always a good idea. Before you try medications, your doctor might suggest that you make some lifestyle changes and begin behavioral therapies.
Such modifications may include changing what, when, and how much you drink, keeping a urination log, creating a bathroom schedule, and practicing relaxation exercises using easy exercises to relax the muscles of your bladder. If these methods fail to improve your symptoms, your doctor may then prescribe medication.
Treating the Cause of OAB
In many cases of OAB, it is impossible to pinpoint an exact cause. However, if and when a cause can be isolated, treatment can be targeted. For instance, neurological disorders like Parkinson’s disease or multiple sclerosis can cause the bladder to contract more often than it should. For men, the cause of bladder issues is often related to an enlarged prostate gland. Bladder stones or cancer may also cause OAB symptoms. If your doctor can diagnose a cause for your OAB, you can expect to receive targeted treatment.
Medications for Unspecified OAB
If your doctor can’t find a cause for your OAB, don’t worry. Often, a specific cause is never found for OAB, but there are medications that treat the symptoms. Some of these drugs work by relaxing the bladder and stopping the involuntary contractions that give you the urge to urinate. Others help to strengthen the tissues around the bladder that may have become weak, while other medications actually decrease how much urine your body produces.
The largest class of drugs used to treat OAB is the anticholinergics. They have this name because they work by blocking a chemical called acetylcholine. This chemical sends the message to the bladder to contract, and by blocking it, these medications minimize the unwanted contractions.
Anticholinergic drugs prescribed for OAB include oxybutynin, toldterodine, trospium, darifenacin, solifenacin, and fesoterodine. All are sold under different brand names, and some are available as generics.
Which anticholinergic medication you try first will be a decision that is up to you and your doctor to decide. In studies that compare the drugs, all had similar levels of effectiveness in patients with OAB.
Side effects are important considerations to keep in mind. For all the anticholinergics, the most common side effect is a dry mouth. Oxybutynin was found to produce more side effects than the other drugs, but these side effects can be minimized by taking the drug in an extended release form.
Tricyclic antidepressants, such as imipramine, can also be used to treat OAB when other medications fail. It has the effect of relaxing the bladder while also contracting the muscles at the neck of the bladder. This means that it reduces the urge to urinate and also helps control leakage and incontinence.
The main side effect of taking imipramine is sleepiness, which makes it a good choice for night-time incontinence or for bed wetting in children. Serious side effects can occur, but are rare.
For women who suffer from OAB caused by weakened support tissues around the bladder, estrogen can help. After menopause, women naturally produce less of this hormone. It works to strengthen the muscles around the bladder, reducing incontinence.
Another hormone medication, desmopressin, is a synthetic form of a natural hormone that controls urine production. Your body should produce more of this hormone at night, reducing the urge to urinate. Desmopressin can mimic its effect and is especially helpful for night time incontinence and bed wetting.
Botox, which is well-known for smoothing out wrinkles, is also a prescription medication that can be used to treat OAB. Like anticholinergics, it blocks acetylcholine, but also paralyzes the muscle of the bladder. This treatment is new, and may not be covered by many insurance plans. However, using Botox for OAB shows promise, and with more research it may become a more accepted type of therapy.
While OAB is no fun to have, if you consult your doctor for a diagnosis and begin treatment, then your outlook is good. The behavioral modifications and lifestyle changes work well for many patients. When those are unsuccessful the medications are often effective at reducing symptoms significantly. In the rare case that medications don’t help with OAB, there are still procedures, including surgery, that can help. Anyone with OAB can resume a normal and comfortable lifestyle with the appropriate treatment.
● Bladder Control Problems: Medications for Treating Urinary Incontinence. (2011, July 30). Mayo Clinic. Retrieved December 4, 2013, from http://www.mayoclinic.com/health/bladder-control-problems/WO00123
● McDonagh, M.S., Selover, D., Santa, J., et al. (2009, March). Drug Class Review: Agents for Over Active Bladder. Oregon Health and Science University. Retrieved December 4, 2013, from http://www.ncbi.nlm.nih.gov/books/NBK47181/#results.s1
● Overactive Bladder (OAB). (2013, March). American Urological Association. Retrieved December 4, 2013, from http://www.urologyhealth.org/urology/index.cfm?article=112
● Overactive Bladder: Treatment and Drugs. (2013, January 16). Mayo Clinic. Retrieved December 4, 2013, from http://www.mayoclinic.com/health/overactive-bladder/DS00827/DSECTION=treatments-and-drugs