Antimuscarinics in the treatment of overactive bladder: does one fit all? Can treatment be individualized?

  • Ceyhun Özyurt

Bull Urooncol 2012;11(4):275-278

Efficacy of antimuscarinic drugs in the treatment of overactive bladder is well known and it is agreed that it is the standard form of treatment. All antimuscarinics are more effective than placebo, but they cause significantly more adverse events when compared with placebo.

The differences of antimuscarinics can be examined under the titles of efficacy, tolerability and safety. It is not evident that there is important differences between the drugs for the case of efficacy, it is dose dependent. There is some differences in tolerability for different side effects. Finally differences between safety profiles are minimal. Then it is expected that any drug should show the same treatment success in all patients. Unfortunately it is not the case actually. Different patients have different expectations from treatments depending on which symptoms are the most bothersome. It is also not the case that same molecule will cause exactly the same side effects at the same severity in different patients. These constitute the concept of clinical effectiveness. Besides additional morbidities of the patient and special conditions may also play a role in choosing the drug.

In this paper it is aimed to bring some suggestions on how to individualise antimuscarinic treatment.

Keywords: overactive bladder, antimuscarinic treatment, individualise the treatment