helplinedonate
  • Announcements

    • ForumAdmin

      Frequently Asked Questions - Step by step guides

      Do you need assistance registering, logging in, posting, etc? Please visit the all new Frequently Asked Question Forum for step-by-step guides. Click the link below to access these helpful guides. Frequently Asked Questions
    • ForumAdmin

      Recursos Nuevos en Español

      http://www.parkinson.org/ayuda   http://www.parkinson.org/espanol    
    • ForumAdmin

      Línea de Ayuda 1-800-473-4636

      Línea de Ayuda 1-800-473-4636   ¿Qué es la línea de ayuda 1-800-4PD-INFO (473-4636) de la Fundación Nacional de Parkinson? Es un número de teléfono gratuito que ayuda a las personas con la enfermedad de Parkinson, sus familiares, amigos y profesionales de salud, a solucionar diferentes inquietudes.   La línea de ayuda ofrece: Información actualizada Apoyo emocional Referidos a profesionales de salud Recursos comunitarios Amplia variedad de publicaciones gratis    
Sign in to follow this  
Followers 0
omalley

Drugs for Urinary Urgency

21 posts in this topic

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.

Share this post


Link to post
Share on other sites

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.

Share this post


Link to post
Share on other sites

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?

Share this post


Link to post
Share on other sites

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.

Share this post


Link to post
Share on other sites

Detrol in Parkinson's disease for urinary incontinence in some cases can lead to confusion as a side effect.

Share this post


Link to post
Share on other sites

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

Share this post


Link to post
Share on other sites

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.

Share this post


Link to post
Share on other sites

We will keep you posted on urinary urgency and Parkinson's disease.

Share this post


Link to post
Share on other sites

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?

Share this post


Link to post
Share on other sites

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.

Share this post


Link to post
Share on other sites

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.

Share this post


Link to post
Share on other sites

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.

Share this post


Link to post
Share on other sites

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.

Share this post


Link to post
Share on other sites

Sometimes adding extra doses at night when he wakes up can be useful.

Share this post


Link to post
Share on other sites

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.

Share this post


Link to post
Share on other sites

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.

Share this post


Link to post
Share on other sites

Dr Okun, I have NEVER in my life had urinary urgency until the last 2 nights in a row.

I have woken up to urinate several times and tried to go back to sleep with the feeling that I never even went.

I have been on Sinemet now for one week. Is this a side effect of using Sinemet?

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!


Register a new account

Sign in

Already have an account? Sign in here.


Sign In Now
Sign in to follow this  
Followers 0