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Preserving cognitive function for patients with overactive bladder: evidence for a differential effect with
1Cognitive Research Corporation, Saint Petersburg, FL 33701, USA. gkay@cogres.com
International Journal of Clinical Practice
|August 14, 2008
Summary
Darifenacin does not impair cognitive function, unlike oxybutynin, in overactive bladder (OAB) treatment. This study compared antimuscarinic agents, highlighting darifenacin
Area of Science:
- Pharmacology
- Neuroscience
- Geriatrics
Background:
- Antimuscarinic agents for overactive bladder (OAB) vary in cognitive side effect potential.
- Darifenacin may have fewer central nervous system (CNS) effects due to low brain concentration and M(1) receptor selectivity compared to oxybutynin.
Purpose of the Study:
- To compare the cognitive effects of darifenacin with other antimuscarinic agents used for OAB.
- To evaluate the potential for CNS adverse effects among different OAB treatments.
Main Methods:
- Reviewed preclinical and randomized controlled trials of cognitive function studies.
- Identified studies evaluating darifenacin, oxybutynin, tolterodine, solifenacin, and trospium.
- Focused on adult participants and human studies for cognitive impact.
Main Results:
- Oxybutynin was consistently linked to cognitive deficits in four studies.
- Darifenacin showed no cognitive impairment in three studies.
- Limited data existed for tolterodine; no human studies evaluated memory for solifenacin or trospium.
Conclusions:
- Darifenacin demonstrated no impairment of memory or cognitive function in controlled trials.
- Oxybutynin showed compelling evidence of cognitive impairment.
- Physicochemical properties, M(1) receptor selectivity, and efflux mechanisms may explain darifenacin's safety profile, crucial for elderly and neurogenic bladder patients.
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