Drug Shows Promise for Bladder Problems
"[With duloxetine] we really for the first time have something that gives them an option for treatment other than wearing pads and living with their problem," says Bump.
Duloxetine is a type of drug known as a selective reuptake inhibitor; over the last few years, these drugs have been very successful in treating various conditions -- such as depression -- by increasing levels of serotonin and other brain chemicals.
Duloxetine increases the amount of serotonin and norepinephrine, another brain chemical, and seems to stimulate the muscles at the opening of the bladder, helping them contract more effectively. Thus, researchers say, accidental urine leakage is controlled.
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."