Overactive Bladder: When You Have to Go, Go, Go
Elliott says both drugs are expensive, costing about $74 per month. The high price of the treatment makes it necessary to know which is the one that gives patients "the best bang for the buck," he says.
Alan Wein, MD, professor and chair of urology at the University of Pennsylvania School of Medicine, took issue with some aspects of the trial, though. The difference in effectiveness of the two drugs, while statistically significant, was not great, he tells WebMD.
The difference in average number of incontinence episodes per week for the two drugs, for instance, was about two, Wein notes.
And he is critical of the study because it did not include a placebo to determine how much of the effects of either drug could be merely random. Finally, Wein says that a new version of Detrol, called Detrol LA -- which, like Ditropan XL, is taken once a day -- has since been developed and been shown to have even lower side effects than what was reported for Detrol.
As for all incontinence medications, Appell says most patients will need to be on medication for an indefinite period of time. But some -- perhaps 30% -- will be able to quit the medication after a short period of treatment, he tells WebMD.
Meanwhile, medication is not the only -- nor necessarily the best -- treatment for overactive bladder, says Lindsey Kerr, MD, director of the Vermont Continence Center in Burlington, Vt. She is also the spokesperson for the National Association for Continence, in Spartanburg, S.C.
"There are probably three or four [nondrug] methods," Kerr tells WebMD. "Any smart physician will not use drugs alone but will use them in combination with other methods because it works better. We don't want patients on drugs for the rest of their lives."
Kerr says typically she will ask patients to keep a diary of how much they drink and how often they use the bathroom. Sometimes, simply decreasing the amount of liquid an individual is drinking can help. Conversely, if a patient is not drinking enough water and fluids, the bladder may be irritated -- another possible cause of overactivity, Kerr says.