Sunday, January 29, 2023

Does Amitriptyline Help Overactive Bladder

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Natural Supplements You Can Take At Home

Drugs Which Cause Dementia | Mark Agresti

While there have been very few scientific studies on herbal remedies as an option for overactive bladder treatment, some remedies have shown promising results for some people.

Studies from Japan have shown improvements in urgency, leakage and a reduction in night-time urination using a herbal remedy known as Gosha-jinki-gan. Also, the buchu plant from South Africa is thought to nourish the bladder tissue and fights inflammation which can lead to infections and incontinence.

There are also plenty of common herbs that may help with symptoms, including:

  • Corn silk
  • Capsaicin
  • Ganoderma lucidum

Remember to consult your doctor first before adding any of these herbal remedies into your overactive bladder management plan.

What Foods And Drinks To Avoid

While you may want to drink less liquid so you dont have to urinate as often, you should still make sure you stay hydrated. More concentrated urine, usually darker in color, can irritate your bladder and cause more frequent urination.

Other foods and drinks can contribute to OAB symptoms, including:

  • alcohol
  • tea
  • tomato-based foods

You can test which drinks or foods irritate your bladder by eliminating them from your diet. Then reincorporate them one by one every two to three days at a time. Permanently eliminate the particular food or drink that worsens your symptoms.

Botox For An Overactive Bladder

Although not commonly used, Botox is a handy muscle relaxer for a variety of conditions, including an overactive bladder. The compound is injected right into the bladder, and patients can experience fewer uncomfortable contractions and increased bladder capacity for up to a year after the injection has taken place.

However, Botox isnt without its dangers. Some patients find that after the procedure they retain urine too much, and experience pain and complications . For these reasons, Botox for overactive bladder treatment is only considered for certain people.

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Medications For Unspecified Oab

If your doctor cant find a cause for your OAB, dont worry. Drugs can still help ease your symptoms. Some of these drugs work by relaxing your bladder. They stop involuntary contractions that bring on the urge to urinate. Other drugs help strengthen the tissues around your bladder that may have become weak. The stronger tissue can help improve your bladder control.

Dosage & Treatment Plan

Dosages for TCAs range from 10 100 mgs usually taken in the evening or at bedtime. It is typical to start out with a very low dose and then gradually increase the dosage every week until you find that your symptoms are improving.

Dosages for other types of antidepressants vary, depending on specific medicine.

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Interstitial Cystitis And Chronic Pain Syndrome

Amy P. Witte, PharmDUniversity of the Incarnate WordFeik School of PharmacySan Antonio, Texas

US Pharm. 2012 37:HS-2-HS-5.

Interstitial cystitis , also known as painful bladder syndrome, is more common than was previously thought however, thedisorder is difficult to diagnose and treat. IC/PBS is part of a groupof conditions that fall under the umbrella of chronic pelvic pain syndrome.1 In the past, a number of other names were used to describe IC/PBS, including urethral syndrome, trigonitis, and bladder pain syndrome.In 1987, the National Institute of Diabetes and Digestive and KidneyDiseases developed the first criteria for the diagnosis of IC. In 2002,the International Continence Society proposed changing the name from ICto IC/PBS and defined the condition as the complaint of suprapubic painrelated to bladder filling, accompanied by other symptoms such asincreased daytime and night time frequency, in the absence of a provenurinary infection and other obvious pathology.2 IC/PBS hasbeen associated with other chronic pain syndromes, such as fibromyalgia,irritable bowel syndrome, and chronic fatigue syndrome. Some expertsbelieve that IC/PBS may be a bladder manifestation of a more generalcondition, such as fibromyalgia or irritable bowel syndrome, that causesinflammation in various organs and areas of the body.

Studies Testing Antidepressants To Treat Ic

With the exception of the TCA called amitriptyline , there are limited studies evaluating the use of antidepressants in IC. While it is general knowledge that TCAs can help with the symptoms of IC and that they are a first-line therapy for IC, it was not until 2004 that researchers put amitriptyline to the test for use in IC in a placebo-controlled study. Researchers tested amitriptyline, the TCA most commonly used to treat IC, in a randomized, prospective, placebo-controlled trial for IC. The researchers found that symptom scores dropped, and that pain and urinary urgency improved significantly in the amitriptyline group compared with the placebo group. Urinary frequency and functional bladder capacity improved more in the amitriptyline group, but the difference was not statistically significant. In a follow-up study, the drug proved to be effective for long-term management of IC.

Researchers out of the Albert Einstein College of Medicine presented a study on another TCA called desipramine at the 2012 American Urological Association meeting. The study found that desipramine was effective in treating both overactive bladder and OAB with bladder pain. The researchers concluded patients treated with amitriptyline should consider desipramine if they experienced side effects linked to amitriptyline, like memory problems.

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Clinical Evaluation And Diagnosis

The clinical presentation of IC/PBS is variable. However, mostpatients present with urgency, frequency, and/or pain. IC/PBS should beconsidered if a patient experiences any of the following symptoms:pelvic pain, dyspareunia, frequent urinary tract infections, frequentvaginitis or prostatitis , nocturia, and urinary frequencyand urgency.4-6

Pain during sexual activity is common in both men and women withIC/PBS. Women may also experience a flare of symptoms during thepremenstrual week. The clinical evaluation of IC/PBS should begin with athorough medical history and physical examination if the patient isexperiencing pain, nocturia, frequency, and/or urgency. In addition, thehistory should include inquiry regarding urinary tract infections,pelvic surgeries, and central nervous system or autoimmune disorders.Even though there are no specific physical-examination findings inIC/PBS, a pelvic examination is important to rule out vaginitis, vulvarlesions, urethral diverticula, and pelvic-floor dysfunction.4-6

Laboratory tests such as urinalysis can help differentiate IC/PBSfrom other conditions. Urinalysis also may be used to rule outhematuria. In addition, a urine culture is required to exclude urinarytract infection. If hematuria is present and the patient is older than40 years of age and has a history of smoking, cytology and CT scan aretypically performed to rule out urinary tract malignancies.4-6

Surgery Is A Last Resort For Restoring Proper Bladder Function

If lifestyle measures, drug treatments, Botox, and neuromodulation therapy are all ineffective at relieving your symptoms, your doctor may consider more drastic surgical treatments for overactive bladder.

These surgical treatments are usually reserved for people with severe symptoms. At this point, two main surgical options are available:

Surgery to increase bladder capacity Surgically increasing the size of your bladder may help relieve pressure and improve its ability to store urine.

In this procedure, your doctor removes pieces of your bowel and uses them to replace a portion of your bladder.

If you have this surgery, you may need to use a catheter intermittently to urinate for the rest of your life.

Bladder removal As a last resort, your doctor may remove your bladder. A replacement bladder, called a neobladder, may be surgically constructed, or your urine may be routed to the outside of your body through a hole in your skin called a stoma.

If you have a stoma following this surgery, youll wear a bag or pouch on your skin to collect your urine.

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How To Take It

Amitriptyline does not usually upset your stomach, so you can take it with or without food.

Swallow the tablets whole with a drink of water. If you chew them, they taste bitter.

The liquid comes with a plastic syringe or spoon to help you measure out the right dose. If you do not have one, ask your pharmacist for one. Do not use a kitchen teaspoon as it will not measure the right amount.

What Is The Role Of Amitriptyline In The Treatment Of Interstitial Cystitis/bladder Pain Syndrome

In a randomized, double-blind, placebo-controlled study, amitriptyline was shown to provide statistically significant improvement in the O’Leary-Sant interstitial cystitis symptom index and problem index, pain, and urgency intensity. Common adverse effects of amitriptyline include dry mouth, weight gain, constipation, and sedation.

In a 2010 intention-to-treat study by Foster et al, 271 women were randomized to behavioral therapy alone or therapy with amitriptyline dose escalation. No difference was found between the amitriptyline and placebo groups overall. However, subgroup analysis showed a mild improvement in symptoms in women on 50 mg of amitriptyline as compared with placebo.

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Eating To Reduce Constipation

Sometimes constipation can place extra pressure on your bladder. You can prevent constipation by exercising regularly and including more fiber in your diet. Foods high in fiber include beans, whole-wheat breads, fruits, and vegetables.

The Cleveland Clinic recommends eating 2 tablespoons of a mixture of 1 cup of applesauce, 1 cup unprocessed wheat bran, and 3/4 cup of prune juice every morning to promote bowel regularity.

About Amitriptyline For Depression

Amitriptyline is an antidepressant medicine. It’s used to treat low mood and depression.

This medicine is only available on prescription. It comes as tablets and as a liquid.

Amitriptyline is also used for some types of pain and to prevent migraines. Find out more about amitriptyline for pain and migraine.

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Anticholinergic Drugs For Oab

The largest class of drugs used to treat OAB is anticholinergic drugs. They work by blocking a chemical in your body called acetylcholine. This chemical sends a message to your bladder to contract. By blocking this chemical, these drugs reduce the contractions that cause you to release urine. In studies that compared the drugs, all anticholinergics worked in treating OAB.

Anticholinergics are sold under different brand names. Some are also available as generic drugs. These medications include:

  • oxybutynin
  • solifenacin
  • fesoterodine

All of these drugs except for Oxytrol come as either tablets or capsules that you take by mouth. Oxytrol is available as a skin patch.

The most common side effects of anticholinergic drugs include:

  • dry mouth
  • blurry vision
  • constipation

Seniors have the greatest risk of side effects from these drugs. These medications may also cause drowsiness and an increased risk of falls in seniors. Oxybutynin may cause more side effects than the other drugs in this class. However, taking oxybutynin in its extended-release form may reduce some of the side effects. Anticholinergics may also worsen dementia symptoms and should be used with caution in people with this disease.

Percutaneous Tibial Nerve Stimulation

This procedure uses a thin needle that is placed through the skin near your ankle to send electrical stimulation from a nerve in your leg to your spine, where it connects with the nerves that control the bladder.

PTNS treatments are delivered once a week for 12 weeks to help treat symptoms of overactive bladder. You will likely need maintenance treatments every three to four weeks to keep symptoms under control.

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How To Cope With Side Effects Of Amitriptyline

What to do about:

  • constipation eat more high-fibre foods such as fresh fruit and vegetables and cereals. Try to drink several glasses of water or other non-alcoholic drinks every day. If you can, it may also help to increase your level of exercise.
  • feeling dizzy this is probably due to low blood pressure. Drink plenty of water or other non-alcoholic drinks. Do not stand up too quickly after you have been sitting or lying down. Do not drive until you stop feeling dizzy.
  • dry mouth try sugar-free gum or sugar-free sweets.
  • feeling sleepy or tired take amitriptyline in the evening and try to cut down the amount of alcohol you drink. Do not drive, cycle or use tools or machinery if you’re feeling sleepy. Talk to your doctor if this does not help.
  • difficulty peeing try to relax when you pee. Do not try to force the flow of urine. If you still cannot go, try again later. Talk to your doctor urgently if you cannot pee at all.
  • headaches make sure you rest and drink plenty of fluids. Try not to drink too much alcohol. Paracetamol and ibuprofen may help if you need pain relief. Talk to your doctor if the headaches last longer than a week or are severe.

Specific Antidepressants May Suppress Symptoms

Specific antidepressants such as Tofranil, Tyramine and Norfranil may help to suppress overactive bladder symptoms. Which one your doctor chooses to prescribe will depend on your particular symptoms.

For example, the SSRI class of antidepressants works better for stress incontinence than for urge incontinence, although its not clear how it helps. Alternatively, tricyclic antidepressants are known to have anticholinergic side effects, which relax the bladder muscle and cause the muscles of the bladder neck to contract.

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Bladder And Bowel Problems After Antidepressants

In addition to sexual problems such as post-SSRI sexual dysfunction and persistent genital arousal disorder , a range of other urological problems linked to antidepressants are increasingly coming into view, and can sometimes be long-lasting after the drugs are stopped. They are likely to be significantly more common than is generally thought, and its definitely worth shining a spotlight on the issue.

As with sexual side effects, some of these problems may be difficult to discuss with your doctor, but in doing so, it may help to increase awareness and recognition that these things are happening.

Common Questions About Amitriptyline

Amitriptyline is from a group of medicines called tricyclic antidepressants. They are thought to work by increasing levels of a chemical called serotonin in your brain. This can improve your mood.

You may find you are feeling better after a couple of weeks, although it usually takes between 4 and 6 weeks before you feel the full benefit of the medicine.

Do not stop taking amitriptyline after 1 or 2 weeks just because you feel it is not helping your symptoms. Give the medicine at least 6 weeks to work.

Antidepressants like amitriptyline help to gradually lift your mood so you feel better. You may notice that you sleep better and get on with people more easily because you’re less anxious. Hopefully you’ll take little things that used to worry you in your stride.

Amitriptyline will not change your personality or make you feel euphorically happy. It will simply help you feel like yourself again.

Do not expect to feel better overnight though. Some people feel worse during the first few weeks of treatment before they begin to feel better.

Once you’re feeling better it’s likely that you will keep taking amitriptyline for several more months. Most doctors recommend that you take antidepressants for 6 months to a year after you’ve stopped feeling depressed. Stopping before then can make depression come back.

Talk to your doctor about the risks and benefits of taking amitriptyline for longer than a few months. It will depend on:

  • feeling dizzy

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How To Talk About Urinary Incontinence

Bringing up the topic of urinary incontinence with your doctor or your spouse is never easy most people are at least a bit embarrassed. But open communication can help you find out about the causes of incontinence and whether your medications may be contributing.

One good opener might be something like this: “I have been having bladder troubles.”

If you will be visiting a new doctor, and have not yet selected them, you might seek out a doctor of the same sex, if you think that would help you feel more comfortable. Or, you might bring up the topic first with your doctor’s nurse.

Preparing for the conversation about urinary incontinence may help you feel more in control. That means being able to answer the questions your doctor is likely to ask, including:

  • When did your urinary incontinence symptoms begin?

Tests Of Bladder Function

Your doctor may order tests to assess how well your bladder is functioning and its ability to empty steadily and completely . These tests usually require a referral to a specialist and may not be necessary to make a diagnosis or begin treatment. Urodynamic tests include:

Your doctor will review the results of any tests with you and suggest a treatment strategy.

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Cholinergic Drugs For Bladder Problems

This class of drugs includes bethanechol . Cholinergic refers to nerve cells or fibers that use a certain type of chemical to send signals within the body. Cholinergic drugs are used when the bladder is not emptied completely following urination. This problem is known as residual urine in the bladder.

  • How cholinergic drugs work: These drugs contract the bladder, thus allowing complete emptying.
  • Who should not use these medications: Individuals with the following conditions should not use cholinergic drugs:
  • Parkinson’s disease
  • Bladder or bowel obstruction
  • Use: Cholinergic drugs are taken by mouth and on an empty stomach .
  • Drug or food interactions: Cholinergic drugs may increase effects of other drugs that also have cholinergic effects, such as tacrine , donepezil , galanthamine , and rivastigmine . Anticholinergic drugs will likely reduce the effect of cholinergic drugs.
  • Side effects: Cholinergic drugs may cause vomiting, diarrhea, watery eyes, headache, dizziness, irregular heartbeat, wheezing, and/or breathing problems. Contact a doctor if these occur.
  • Dosage And Strength Of Standard Tablets

    Standard tablets come as either 2.5mg, 3mg or 5mg.

    The usual starting dose of 2.5mg is 1 tablet, taken twice a day, in the morning or evening, or 1 tablet, taken 3 times a day.

    If you take 3 doses a day, space each dose evenly throughout the day. You could take it first thing in the morning, in the middle of the afternoon and at bedtime.

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    Dosage And Strength Of Liquid

    Oxybutynin is available as a liquid for children and people who find it difficult to swallow tablets. It comes in 2 strengths:

    • 2.5mg of oxybutynin in a 5ml spoonful
    • 5mg in oxybutynin in a 5ml spoonful

    The usual starting dose for an adult is 5mg, taken twice a day , or 5mg, taken 3 times a day.

    The dose will usually be lower for adults over 65 and children.

    If you take 3 doses a day, space each dose evenly throughout the day. You could take it first thing in the morning, in the middle of the afternoon and at bedtime.

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