A drug used to treat depression may be a safer alternative for women with stress urinary incontinence (SUI) than some other treatments, according to a study published in the British Journal of Clinical Pharmacology.

Duloxetine is approved by the Food and Drug Administration (FDA) to treat depression and general anxiety disorder, as well as pain and tingling caused by diabetic neuropathy, fibromylgia, and ongoing bone or muscle pain. It is in a class of medications called selective serotonin and norephinephrine reuptake inhibitors (SNRIs). It works by increasing the amount of serotonin and norepinephrine, natural substances in the brain that help maintain mental balance and stop the movement of pain signals in the brain.

Researchers conducted an observational study involving 6,854 patients who were seeing urologists and gynecologists, and 5,879 patients who were seeing primary care physicians. All were newly started on treatment for moderate-to-severe SUI. Urology and gynecology patients were followed for 12 weeks while primary care patients were followed for 24 weeks. Patients either received duloxetine or another conservative treatment.

Researchers found that duloxetine appeared to be safe for the routine clinical care of SUI. The spectrum of side effects was the same as in controlled studies but the frequency was lower. Common side effects from duloxetine include nausea, vomiting, constipation, diarrhea and headaches. More serious symptoms include unusual bleeding, swelling of the abdomen, blisters or peeling and difficulty breathing or swallowing.

The potential adverse reactions appear less traumatic than those from other treatments for SUI, such as the use of bladder slings. The slings, made of surgical mesh, are inserted through the vagina to hold up the bladder. It is the same type of surgical mesh and same basic procedure used to treat pelvic organ prolapse.

Last year the FDA issued a warning that transvaginal mesh has been linked to deaths and injuries in women and that some women had to undergo multiple surgeries to remove mesh that had moved or eroded.

Source: Doctor’s Lounge

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