Drug Shows Promise for Bladder Problems
Because it affects brain chemicals rather than blood vessels,
duloxetine doesn't increase blood pressure.
The clinical trials were conducted at 48 centers across the
U.S., involving 535 women between 18 and 65 years old. All women were having at
least four episodes a week for at least three months.
Women taking 40 mg of duloxetine twice a day had significant
effects -- a 64% to 100% reduction in frequency of incontinence episodes. Also,
a subset of 163 women who had more severe incontinence -- at least 14 episodes
per week -- also had significant decrease of symptoms.
In a quality-of-life survey, 44% of women reported feeling
"very much better" or "much better," compared with 27% of those
taking the placebo.
Niall Galloway, MD, medical director of the Emory Continence
Center at Emory University School of Medicine in Atlanta, agreed to review the
study for WebMD. He offers a bit more background on duloxetine.
"Actually, duloxetine was being studied for another use --
as a treatment for depression," says "But when women began reporting
that their leakage problems were improved, a second study to investigate that
finding was launched," Galloway says.
Bump's study is "quite good," he tells WebMD.
"There does seem to be a big difference in terms of benefit between the two
groups. Also, what's always encouraging -- as the dose increases, the benefits
increase. That would imply that the medication truly is the factor
However, exactly how duloxetine affects bladder action isn't
quite clear, says Galloway. "We always want to know what the mechanism of
action is, and that is not at all clear."
Also, a medication often produces an effect in the short term
-- for just a few weeks, as in Bump's study. "But when taken for a
prolonged interval, it's not clear whether the physiological effects on
incontinence would be sustained," Galloway says.
Another issue: Will patients want to take an antidepressant for
a bladder problem? Possibly not, says Galloway. "Patients want a treatment
that corrects the problem; they don't want a medication that's going to have an
affect on their emotional state."
If indeed the drug is effective, then similar medications could
also accomplish the same thing, Galloway says.
The duloxetine study is supported by Eli Lilly and Company, a