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Drugs for Urinary Urgency


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#1 omalley

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Posted 16 August 2013 - 10:49 AM

67 year old male, good health, daily exercise. PD for last 7 years. On Sinemet (3X100), Isradipine, Rasagiline and FloMax. Was prescribed Detrol 4mg Sustained Release for frequent urination and sense of urgency. Modest effectiveness with the drug. Is there another drug that might be more effective that I should consider trying? Thank you.

#2 Dr. Okun

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Posted 16 August 2013 - 11:14 AM

People have tried all sorts of urinary urgency drugs in Parkinson's disease with mixed successes; mostly the worry is that they all block acetylcholine and that this can worsen cognition-- we therefore usually advocate seeing a urologist and weighing the risks and benefits of medical treatment. I will post for you for other thoughts, but I don't have a magic bullet for this one.
Michael S. Okun, M.D.
Author of the Amazon Bestseller Parkinson's Treatment: 10 Secrets to a Happier Life
National Medical Director | NPF
UF Center for Movement Disorders & Neurorestoration
Read More about Dr. Okun at: http://movementdisor...hael-s-okun-md/
or Visit Parkinson's Disease treatment and research blogs at:
NPF's What's Hot in Parkinson's disease
or his parkinsonsecrets.com blog for treatment tips

#3 Golden01

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Posted 16 August 2013 - 07:55 PM

Seems like a couple of years ago there was a clinical trial underway looking at "bladder training" in PD. Any results or does "bladder training" work in PD patients?

Husband diagnosed in 2005-Medicines: Azilect, Artane, and Amantadine; Sister and Best Friend from Childhood also have PD


#4 Dr. Okun

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Posted 17 August 2013 - 08:41 AM

I have done a few searches looking for any true research studies on bladder training and Parkinson's disease and I can't seem to find any. I will post this and see if anyone is aware of one.
Michael S. Okun, M.D.
Author of the Amazon Bestseller Parkinson's Treatment: 10 Secrets to a Happier Life
National Medical Director | NPF
UF Center for Movement Disorders & Neurorestoration
Read More about Dr. Okun at: http://movementdisor...hael-s-okun-md/
or Visit Parkinson's Disease treatment and research blogs at:
NPF's What's Hot in Parkinson's disease
or his parkinsonsecrets.com blog for treatment tips

#5 Ljubica Lojan

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Posted 18 August 2013 - 11:04 AM

We experienced that without Detrol is even worse. Incontinence could be related to prostate problems as well.

#6 Dr. Okun

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Posted 18 August 2013 - 07:25 PM

Detrol in Parkinson's disease for urinary incontinence in some cases can lead to confusion as a side effect.
Michael S. Okun, M.D.
Author of the Amazon Bestseller Parkinson's Treatment: 10 Secrets to a Happier Life
National Medical Director | NPF
UF Center for Movement Disorders & Neurorestoration
Read More about Dr. Okun at: http://movementdisor...hael-s-okun-md/
or Visit Parkinson's Disease treatment and research blogs at:
NPF's What's Hot in Parkinson's disease
or his parkinsonsecrets.com blog for treatment tips

#7 recumbent rider

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Posted 23 August 2013 - 10:25 PM

Dr. Okun,

Try http://clinicaltrial...how/NCT00866710

Kind regards,

George

#8 Dr. Okun

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Posted 24 August 2013 - 06:25 AM

There is a behavioral therapy treatment for incontinence being tried in the setting of a research trial at the Atlanta VA and it is being done on Parkinson's disease patients. Thanks for providing the clinical trials link: http://clinicaltrial...how/NCT00866710
Michael S. Okun, M.D.
Author of the Amazon Bestseller Parkinson's Treatment: 10 Secrets to a Happier Life
National Medical Director | NPF
UF Center for Movement Disorders & Neurorestoration
Read More about Dr. Okun at: http://movementdisor...hael-s-okun-md/
or Visit Parkinson's Disease treatment and research blogs at:
NPF's What's Hot in Parkinson's disease
or his parkinsonsecrets.com blog for treatment tips

#9 Golden01

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Posted 31 August 2013 - 09:04 AM

George and Dr. Okun, Thanks for the link! This is the study I had heard about when they began recruiting. Keep us posted when they have results. Hope the study turns out positive.

Husband diagnosed in 2005-Medicines: Azilect, Artane, and Amantadine; Sister and Best Friend from Childhood also have PD


#10 Dr. Okun

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Posted 01 September 2013 - 05:43 AM

We will keep you posted on urinary urgency and Parkinson's disease.
Michael S. Okun, M.D.
Author of the Amazon Bestseller Parkinson's Treatment: 10 Secrets to a Happier Life
National Medical Director | NPF
UF Center for Movement Disorders & Neurorestoration
Read More about Dr. Okun at: http://movementdisor...hael-s-okun-md/
or Visit Parkinson's Disease treatment and research blogs at:
NPF's What's Hot in Parkinson's disease
or his parkinsonsecrets.com blog for treatment tips

#11 recumbent rider

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Posted 01 September 2013 - 08:02 PM

Dr. Okun,
I found published results for this pilot study in Neurology, http://www.neurology.org/content/76/19/1631.abstract. It looks like they are recruiting for a phase three study, http://clinicaltrial...1/2013&lup_d=3.

Kind regards,
George

#12 vipowitz

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Posted 01 September 2013 - 08:12 PM

Dr Okun, My urinary urgency seems to be confined to my sleep cycle, waking up multiple times during the night to urinate ( no accidents). On a good night, it may be only 2 times, on a particularly bad night it can be once per hour. Over the last couple of years frequency of nighttime urgency has not really worsened. I have tried vesicare, Avodart, Flomax, rapaflow and a couple of older generic drugs. None seems to make any appreciable difference. I also have been diagnosed with degenerative cervical disc disease. Is this scenario common in PD?

#13 Dr. Okun

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Posted 02 September 2013 - 07:13 AM

This scenario is very common in Parkinson's disease- waking up with urinary urgency and frequency. We usually also add sinemet doses when people wake up and also seek a sleep study as treatment of apnea in Parkinson's disease can also help this issue.
Michael S. Okun, M.D.
Author of the Amazon Bestseller Parkinson's Treatment: 10 Secrets to a Happier Life
National Medical Director | NPF
UF Center for Movement Disorders & Neurorestoration
Read More about Dr. Okun at: http://movementdisor...hael-s-okun-md/
or Visit Parkinson's Disease treatment and research blogs at:
NPF's What's Hot in Parkinson's disease
or his parkinsonsecrets.com blog for treatment tips

#14 Ljubica Lojan

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Posted 03 September 2013 - 10:38 AM

My husband has urinary accidents over the night. He is on Sinemet, Sinemet CR and Detrol. Would you suggest to add Sinemet in addition to Sinemet CR over the night. Our specialist did not go to that route.

#15 Dr. Okun

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Posted 03 September 2013 - 08:07 PM

Probably not, but if he awakens in the night and is stiff and rigid you could re-dose. Also you could consider a sleep study.
Michael S. Okun, M.D.
Author of the Amazon Bestseller Parkinson's Treatment: 10 Secrets to a Happier Life
National Medical Director | NPF
UF Center for Movement Disorders & Neurorestoration
Read More about Dr. Okun at: http://movementdisor...hael-s-okun-md/
or Visit Parkinson's Disease treatment and research blogs at:
NPF's What's Hot in Parkinson's disease
or his parkinsonsecrets.com blog for treatment tips

#16 Ljubica Lojan

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Posted 03 September 2013 - 08:47 PM

My husband did a sleep study, which was normal. I thought that Sinemet CR may not be enough through the night. At times he wakes up every night. On good days he wakes up twice. Usually he has accidents before reaching for urinal. His PD medications include Azilect, Sinemet, Sinemet CR. During the day he has a good control.

#17 Dr. Okun

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Posted 04 September 2013 - 06:24 AM

Sometimes adding extra doses at night when he wakes up can be useful.
Michael S. Okun, M.D.
Author of the Amazon Bestseller Parkinson's Treatment: 10 Secrets to a Happier Life
National Medical Director | NPF
UF Center for Movement Disorders & Neurorestoration
Read More about Dr. Okun at: http://movementdisor...hael-s-okun-md/
or Visit Parkinson's Disease treatment and research blogs at:
NPF's What's Hot in Parkinson's disease
or his parkinsonsecrets.com blog for treatment tips

#18 Golden01

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Posted 05 September 2013 - 08:44 AM

I wish the study included a group of patients that just have urinary frequency but have not yet developed incontinence. Seems like intervening earlier rather than later might be more likely to have positive results. If the study shows the behavioral therapy isn't effective, it may dismissed when there's a possibility it could be effective in a different type of patient. If I were funding the study, I'd add another arm of the study to evaluate outcomes! The results might help a lot of us get more sleep.

Husband diagnosed in 2005-Medicines: Azilect, Artane, and Amantadine; Sister and Best Friend from Childhood also have PD


#19 Dr. Okun

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Posted 06 September 2013 - 06:47 AM

Great points. I should point out that if you have urinary urgency or frequency you can see physical and occupational therapists in many practices who will train you on behaviorally based exercises.
Michael S. Okun, M.D.
Author of the Amazon Bestseller Parkinson's Treatment: 10 Secrets to a Happier Life
National Medical Director | NPF
UF Center for Movement Disorders & Neurorestoration
Read More about Dr. Okun at: http://movementdisor...hael-s-okun-md/
or Visit Parkinson's Disease treatment and research blogs at:
NPF's What's Hot in Parkinson's disease
or his parkinsonsecrets.com blog for treatment tips




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