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Medical Author:

Siamak T. Nabili, MD, MPH

Siamak T. Nabili, MD, MPH

Dr. Nabili received his undergraduate degree from the University of California, San Diego (UCSD), majoring in chemistry and biochemistry. He then completed his graduate degree at the University of California, Los Angeles (UCLA). His graduate training included a specialized fellowship in public health where his research focused on environmental health and health-care delivery and management.

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Medical Editor:

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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The most common group of medications used to treat overactive bladder are the anticholinergic drugs. These medications work by diminishing the activity of and relaxing the detrusor muscle. As a group, they have similar side effects, including dry mouth, blurry vision, constipation, and confusion, especially in the elderly. These drugs for OAB are taken by prescription only and should be taken under the supervision of the prescribing doctor.

The following are anticholinergic medications used for OAB:

• Oxybutynin (Ditropan) is taken two to three times a day. The extended-release form, Ditropan XL, can be taken once a day. There is also a patch form, Ditropan patch or oxybutynin (Oxytrol), which can be placed on the skin once or twice per week.



• Tolterodine (Detrol) produces less dry mouth as a side effect and can be taken twice a day. The extended-release type, Detrol LA, is taken once a day.



• Solifenacin (VESIcare) is also used once a day and is relatively new in this group of medications.



• Darifenacin (Enablex) has the least confusion-type side effects and is recommended for the elderly with dementia. It is also taken once daily.



• Fesoterodine fumarate (Toviaz) is a once a day medication.

Other than anticholinergic medications, occasionally antidepressant medications are used for treatment of overactive bladder. More specifically, duloxetine (Cymbalta) has shown some benefit in treating the urinary symptoms of overactive bladder, although it is currently not approved by the U.S. Food and Drug Administration (FDA) for this purpose.

Estrogen preparations, orally or vaginally, are sometimes used in postmenopausal women with incontinence.

Some of the newer therapies for overactive bladder include Botox injection into the detrusor muscle. This has been used only experimentally with relative success in some people who otherwise have not responded to more traditional treatments for OAB. Again, Botox is not approved for this use by the FDA.

Herbal and natural remedies for overactive bladder have not been studied scientifically and even though they have been traditionally used for a long time, their effectiveness is greatly unknown. Some of the commonly used herbal therapies for overactive bladder are buchu (Barosma betulina), cleavers, corn silk, horsetail, saw palmetto, and gosha-jinki-gan. Despite availability of these natural and homeopathic therapies for overactive bladder, many experts recommend using them with caution and encourage reviewing these options with a naturopathic doctor.

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