Antimuscarinics for the treatment of overactive bladder: a review of central nervous system effects.
Antimuscarinic drugs commonly used to treat overactive bladder are often associated with central nervous system (CNS) side effects including cognitive dysfunction, memory impairment, dizziness, fatigue, and headache. New agents show reduced CNS penetrance and better selectivity for the M3 muscarinic receptor. However, changes associated with aging may lead to alterations in blood-brain barrier permeability. Therefore, use of antimuscarinics in the elderly or in patients with Alzheimer's disease presents a significant challenge. This review highlights muscarinic receptor distribution and function in the CNS, provides a description and incidence of CNS side effects with therapy, offers information specific to currently available agents, and describes the use of antimuscarinics in special populations including children, the elderly, and patients with Alzheimer's disease.
Division of Urology, Virginia Commonwealth University School of Medicine, PO Box 980118, Richmond, VA 23298, USA. apklausner@vcu.edu
Adam P
AP
Klausner
William D
WD
Steers
D000328:Adult; D017677:Age Distribution; D000368:Aged; D002493:Central Nervous System Diseases / Q000139:chemically induced* / Q000453:epidemiology / Q000503:physiopathology; D002648:Child; D003072:Cognition Disorders / Q000139:chemically induced* / Q000453:epidemiology; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D018727:Muscarinic Antagonists / Q000009:adverse effects* / Q000627:therapeutic use; D011379:Prognosis; D018570:Risk Assessment; D012720:Severity of Illness Index; D017678:Sex Distribution; D053201:Urinary Bladder, Overactive / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D014563:Urodynamics
D018727:Muscarinic Antagonists