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Drug Shows Promise for Bladder Problems

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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 here."

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 WebMD sponsor.

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