Urinary Incontinence Medications: To take or not to take?

  • Previously I have discussed options for treatment of incontinence, including overactive bladder, and options one may have other than taking medications. That being said, certain medications, a class called anticholinergics, are often the best and the easiest treatment for overactive bladder. After a thorough work-up of my patients, I often find that those people with overactive bladder will get the most improvement from taking these medications. After my patients take the medication and have improvement of their symptoms, the next question I usually get is “how long will I have to take these?”
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    The answer is, “I don’t know.”

    The first medications used to treat overactive bladder are still used today, but often come with a fair amount of side effects. The most common and bothersome symptoms are constipation and dry mouth. If you stay on the medications for a while, most people will overcome the symptoms, but others cannot tolerate it. The original medications for this are short acting and need to be taken at least three to six times a day. Many people find this difficult to adhere to (I do), and found that the relief they got ended up being minimal because of infrequent or irregular dosing.

    Then came the next generation of medications. Some of the same medications were reformulated to be long acting, therefore reducing the side effect profile, and making it easier to remember to take them. People still may experience the side effects but to a lesser or shorter extent.

    To make things even more confusing, two new types of anticholinergics have come out in the last few years in the United States. One of them has been in Europe for years with a great deal of success. These new medications (three to be exact) often have fewer side effects and work better for many people, and have quickly gained popularity for the treatment of overactive bladder in this country. That being said, not everyone finds that these meds work better than the older, less expensive ones either.

    So, does someone need to take these medications for the rest of their life? Maybe.

    Your doctor may find that you are an appropriate patient for these bladder medications and have you start taking them. Some people need to take them for 3-6 months only and find that their bladder has now been “retrained”. Other people need to take them for a lifetime to control their symptoms. The only way to know is to stop taking them after a while and see how you do. This should be discussed with your doctor before stopping this medication, or any other medication for that matter. You may have been given this prescription for a more serious condition and not realize it. It would be unsafe to stop these medications in that situation. For most people, this is not the case, but make sure to discuss it with your doctor anyhow.

    Another important point is that even though those medications are very similar to each other, people respond to each of them differently. If your doctor has placed you on one medication and you are not seeing results or the side effects are undesirable, make sure to ask to be placed on a different one. Many doctors don’t realize that one pill may work better than another for you because they are so similar, so make sure to ask, and even insist on a different pill if you want to continue to try medication for your symptoms.

  • The truth is, if you are on these medications and you are getting good control of your bladder, there is no reason to stop them for safety reasons. These medications have stood the test of time, and are safe for long-term use. A person needs to make the decision for himself if staying on the medication or having overactive bladder is what they choose to live with. Only you can make that decision for yourself.
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Published On: December 11, 2006