Antimuscarinics in multiple sclerosis: A systematic review

Multiple sclerosis (MS) is an immune-mediated disease, impacting the central nervous system, resulting in a wide range of symptoms. Lower urinary tract symptoms (LUTS) are one of the common symptoms in MS patients and antimuscarinic drugs (AMs) are suggested as the first-line treatment in MS-related LUTS. This systematic review evaluates any impacts of AMs on MS patients. The study was conducted following the PRISMA statement and JBI methods. A comprehensive search in four major databases including PubMed, Scopus, Embase, and Web of Science was accomplished, and the clinical evidence regarding the effects of AMs in MS patients was considered for inclusion. Out of 858 studies found by the systematic search as well as the handsearching, 15 studies were included. The studies' sample sizes ranged from 20 to 576 MS participants, with a mean age between 45 and 53 years and female dominance in study populations. The studies noted a significant improvement in urinary outcomes with AMs and also shed light on the cognitive deficits due to AMs consumption. Other common side effects consist of dry mouth (xerostomia) and dizziness. AMs showed an improvement in quality of life and sleep problems by controlling LUTS in MS patients. Despite the remarkable effectiveness, considering the cognitive side effects, more caution should be exercised as MS patients are already at risk for cognitive dysfunctions.