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Antidepressants for Urinary Incontinence


Examples

Generic NameBrand Name
duloxetineCymbalta, Tofranil
imipramineCymbalta, Tofranil

This medicine is usually taken as pills or liquid (orally).

How It Works

Duloxetine is an antidepressant called a "selective serotonin and norepinephrine reuptake inhibitor." It changes how the brain uses certain brain chemicals. How it helps with bladder control is not yet known.

Imipramine is a tricyclic antidepressant, but it has anticholinergic side effects. This means that it relaxes the smooth muscle of the bladder. It also causes the muscles at the bladder neck to contract.

Why It Is Used

Duloxetine may be prescribed for stress incontinence.

Imipramine may be prescribed for:

How Well It Works

Duloxetine rarely cures stress incontinence. But it can reduce the number of times you leak urine. People taking duloxetine also felt it improved their quality of life.1 But duloxetine can cause side effects. The number of women who have fewer symptoms with duloxetine is about the same as the number of women who stop taking it because of side effects.2

Imipramine is not a well-studied incontinence treatment. It is not known as a highly effective treatment for urinary incontinence. But it may be worth trying if other medicines don't work or if they cause side effects.

Side Effects

All medicines have side effects. But many people don't feel the side effects, or they are able to deal with them. Ask your pharmacist about the side effects of each medicine you take. Side effects are also listed in the information that comes with your medicine.

Here are some important things to think about:

  • Usually the benefits of the medicine are more important than any minor side effects.
  • Side effects may go away after you take the medicine for a while.
  • If side effects still bother you and you wonder if you should keep taking the medicine, call your doctor. He or she may be able to lower your dose or change your medicine. Do not suddenly quit taking your medicine unless your doctor tells you to.

Callor other emergency services right away if you have:

  • Trouble breathing.
  • Swelling of your face, lips, tongue, or throat.

Duloxetine

Call your doctor if you have:

Common side effects include:

Imipramine

Call your doctor if you have:

  • A dry mouth for more than 2 weeks.
  • Confusion, delirium, or hallucinations.
  • Hives.
  • Problems with urination, including difficulty beginning to urinate, a urine stream that stops and starts, a weak urine stream, a need to strain while urinating, or a sense that the bladder is not empty after urination.
  • Thoughts of suicide.
  • Vision problems.

Common side effects include:

  • Dizziness or drowsiness.
  • Dry mouth, nose, throat, and eyes.
  • Headache.
  • Nausea.
  • Weight gain.

The U.S. Food and Drug Administration (FDA) has issued an advisory on antidepressant medicines and the risk of suicide. Talk to your doctor about these possible side effects and the warning signs of suicide.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What To Think About

Imipramine can make drowsiness worse when it is combined with alcohol or other medicines that make you sleepy. These include cold and allergy medicines. Check with your doctor before taking any other medicines with imipramine, including medicine you can get without a prescription. If you are feeling sleepy, don't drive or do anything else that could be dangerous to you or other people.

Imipramine may cause your skin to be more sensitive to sunlight. When you are taking this medicine:

  • Stay out of the sun, if possible.
  • Wear long pants, long-sleeved shirts, and hats, if possible.
  • Use sunscreen with an SPF that your doctor recommends.
  • Call your doctor if you have a severe reaction after being in the sun.

Dry mouth is common when you take imipramine. To help with dry mouth, you can chew sugarless gum, suck on sugarless candy, or melt ice in your mouth. If you continue to have problems with dry mouth after a couple weeks, call your doctor. Dry mouth can lead to tooth decay and gum disease.

Taking medicine

Medicine is one of the many tools your doctor has to treat a health problem. Taking medicine as your doctor suggests will improve your health and may prevent future problems. If you don't take your medicines properly, you may be putting your health (and perhaps your life) at risk.

There are many reasons why people have trouble taking their medicine. But in most cases, there is something you can do. For suggestions on how to work around common problems, see the topic Taking Medicines as Prescribed.

Advice for women

If you are pregnant, breast-feeding, or trying to get pregnant, do not use any medicines unless your doctor tells you to. Some medicines can harm your baby. This includes prescription and over-the-counter medicines, vitamins, herbs, and supplements. And make sure that all your doctors know that you are pregnant, breast-feeding, or planning to get pregnant.

Checkups

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

Complete the new medication information form (PDF)Click here to view a form.(What is a PDF document?) to help you understand this medication.

References

Citations

  1. Mariappan P, et al. (2005). Serotonin and noradrenaline reuptake inhibitors (SNRI) for stress urinary incontinence in adults. Cochrane Database of Systematic Reviews (3).

  2. Shamliyan T, et al. (2012) Nonsurgical treatments for urinary incontinence in adult women: Diagnosis and comparative effectiveness. Comparative Effectiveness Review No. 36 (AHRQ Publication No. 11[12]-EHC074-EF). Rockville, MD: Agency for Healthcare Research and Quality. Available online: www.effectivehealthcare.ahrq.gov/search-for-guides-reviews-and-reports/?pageaction=displayproduct&productid=1021.

Credits

ByHealthwise Staff
Primary Medical ReviewerE. Gregory Thompson, MD - Internal Medicine
Specialist Medical ReviewerAvery L. Seifert, MD - Urology
Last RevisedSeptember 11, 2012

eMedicineHealth Medical Reference from Healthwise

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