To treat an overactive bladder, various irritable bladder medications are available. In most cases they are so-called anticholinergics. These reduce the symptoms effectively, however, they can bring significant side effects. The selection of appropriate irritable bladder drugs should therefore be in close consultation with the patient’s therapeutic goals. Find out about irritable bladder medications here.
Effect of anticholinergics
Drug therapy is often prescribed concomitantly with the training and training of the bladder. Most often come as irritable bladder medications anticholinergics used, which inhibit the nerves that are responsible for the irritative symptoms. They do this by blocking certain docking sites (receptors) for the transmitter (transmitter) acetylcholine.
The effectiveness and effect depends on the specificity of blocking the desired docking sites. These receptors are located throughout the body. The urinary bladder contains the receptor subtypes M2 and M3. Above all, the M3 receptor must be blocked in order to inhibit the bladder muscles. However, if the irritable bladder drugs also act on other receptor subtypes, it can lead to (significant) side effects.
Side effects and interactions
In the context of prescribing anticholinergics, it is important to examine medications taken in parallel for potential interactions and effects of the irritable bladder medications.
Basically, the intake of anticholinergics may be associated with a number of side effects. These can mainly affect the eyes, the gastrointestinal tract and the central nervous system. Notably, patients complain of mouth and eye dryness and constipation. The cognitive function can also be influenced, which is especially important in older patients. The side effects occur depending on the preparation used. Sufferers may also discontinue these irritable bladder medications.
Instead of putting off the medication intimidated by the side effects, one should rather seek the conversation with his doctor. This may possibly switch to another preparation. After discontinuing the drug, the side effects usually disappear. There are also a number of contraindications to the use of anticholinergics. The irritable bladder medications should not be used for glaucoma, gastrointestinal tract narrowing or urinary retention.
Choosing the right anticholinergic
There are a variety of different preparations from the group of anticholinergics, which can be selected depending on the symptoms and known side effects. Oxybutinin and tolterodine are particularly common – they have relatively few side effects. Oxybutyinin can be used not only as a tablet but also as a patch. The use of this so-called transdermal patch has significantly fewer side effects. The preparation darifenacin is particularly specific for receptor blockade on the bladder. Trospium chloride is used primarily to prevent central nervous system side effects. The majority of these irritable bladder medications even need to be taken only once a day.
Overall, the use of anticholinergics is recommended as irritable bladder therapy. Around 60 to 75 percent of those affected experience relief from this irritable bladder therapy. If the effect does not occur, the dose can be increased.
Local estrogen therapy
In some women, the symptoms of irritable blisters are due to a lack of estrogen, especially after the onset of menopause. With them usually a so-called local estrogenization carried out. It is usually introduced as a cream or ointment estrogens locally into the vagina. This should be strengthened with permanent use, the elasticity of the pelvic floor. Compared with placebo, women with overactive bladder were shown to benefit from this. Alternatively, estrogen can also be supplied in the form of tablets (systemically).
Other irritable bladder medications
Other irritable bladder medications are the Beta-3 agonists (Mirabegron). Unlike anticholinergics, they stimulate receptors for norepinephrine. This stimulation causes the bladder muscles to be inhibited – this combats incontinence. The side effects should be slightly lower than the anticholinergics.
Show the irritant bladder–Medication after six weeks of therapy, weaning should be attempted. If necessary, the therapy can also be continued in consultation.
If the symptoms do not improve despite irritable bladder medication, there has been a new method of treatment for several years: the injection of Botox. The neurotoxin acts locally on the nerves of the bladder and helps to suppress unjustified urination. However, the duration of such an injection is limited to six months. Nevertheless, patients often experience a noticeable improvement in their quality of life. Beats none of the irritable bladder–drugs Neuromodulation or a bladder pacemaker may also be considered.