Overactive bladder (OAB) syndrome is a long-term medical condition, where a person has a sudden urge to immediately urinate. A doctor may prescribe anticholinergic medications to help treat OAB.

People with OAB may also have difficulty holding urine in or have urinary incontinence. They may feel the need to urinate very frequently, particularly at nighttime. This is all in the absence of any urinary tract infections (UTIs).

According to the National Overactive Bladder Evaluation study, OAB affects approximately 33 million American adults. However, the study may not be accurate as people with OAB often do not report they have the condition. Some people may feel embarrassed or not even realize they are experiencing it.

The risk of developing OAB typically increases with age and can affect all genders.

This article explores how anticholinergic medications work, the types that are available to treat OAB, and some common side effects. It also discusses when to speak with a doctor.

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Neurotransmitters are chemicals that send messages through a person’s nervous system to other systems in their body. They help regulate a range of functions in the body.

The neurotransmitter acetylcholine (ACh) activates the parasympathetic nervous system (PNS), which is responsible for regulating certain bodily functions, including urination.

Within the PNS, ACh activates the muscarinic receptors, which contract the muscle responsible for pushing urine out of the bladder, known as the detrusor muscle. When the muscarinic receptors are not working correctly, they may overstimulate and contract the bladder more frequently, leading to OAB.

Anticholinergics are a group of medications that restrict the activity of ACh and can inhibit the muscarinic receptors, stopping them from overly contracting the bladder.

According to a 2021 study, antimuscarinics, which are a type of anticholinergic medication, remain the most widely used treatment for urinary urgency, and several scientific organizations recommend their use for the treatment of OAB.

There are several types of anticholinergic medications that a doctor may prescribe to treat OAB.

According to 2021 research, studies have not been conclusive about which type of anticholinergic medications are the most effective for treating OAB. However, some anticholinergics can provide modest, but important, improvements in symptom control. As such, people may need to try different anticholinergics to see which ones are most tolerable and effective for them.

Some of the anticholinergic medications that healthcare professionals may prescribe to treat OAB include:

  • Oxybutynin: This medication comes in immediate- or slow-release tablet form, liquid, gel, or skin patches. A doctor may advise a person to take one immediate-release tablet two to three times daily or one slow-release tablet per day. People may take oxybutynin liquid two to three times daily. If a person is using skin patches, they may apply one fresh patch to the skin twice per week.
  • Solifenacin: This medication may not be suitable for people with certain health conditions, such as glaucoma or Crohn’s disease, or if they are pregnant. If a doctor does prescribe solifenacin for OAB, a person may typically take one tablet per day.
  • Fesoterodine: This is a slow-release medication. Typically, fesoterodine comes in tablet form, and a person may take one tablet per day to treat OAB. It may not be suitable if a person is pregnant though.
  • Darifenacin: Thisis another slow-release medication that may not be suitable if a person is pregnant. Typically, darifenacin comes in tablet form, and a person may take one tablet per day to treat OAB.
  • Tolterodine: This medication may not be suitable if a person has certain health conditions, such as glaucoma, heart problems, or acid reflux. If a doctor does prescribe tolterodine for OAB, a person may take one immediate-release tablet twice daily, or one slow-release tablet per day.
  • Trospium: This medication comes in immediate- and slow-release tablet form. A person may take one immediate-release tablet twice daily, or one slow-release tablet per day.

Recommended dosages may vary depending on a person’s age and other factors. A person should speak with a doctor about how often to take their anticholinergic medication and whether they have any other health conditions.

There are muscarinic receptors throughout the body, and anticholinergic medications are not able to specifically target the muscarinic receptors of the urinary tract. Therefore, they can affect other receptors in the body. This means that adverse side effects can be common.

Research from 2021 suggests that the most common side effects are dry mouth and constipation. Some other common side effects may include:

  • blurry vision
  • itchy skin
  • tachycardia
  • drowsiness
  • cognitive issues, such as trouble with memory, learning new things, concentration, and making decisions
  • headaches

Typically, the higher the dosage of anticholinergic medications, the more side effects a person is likely to experience.

If a person is elderly or is already taking anticholinergic medications for other conditions, they may be more vulnerable to adverse effects. There are also several health conditions that may become worse if a person takes anticholinergic medications, including:

Anticholinergic medications may also interact with other medications a person is taking. Therefore, people should speak with a doctor for further advice before taking anticholinergic medications.

If a person has been taking high doses of anticholinergic medications and is approaching the range of having toxic levels of anticholinergic in their body, they may experience some serious side effects.

A person should contact a doctor if they experience any of the following symptoms:

People should also speak with a healthcare professional before taking any anticholinergic medications. A healthcare professional can advise which medications may work best or offer alternative treatment recommendations on an individual basis.

Overactive bladder is a long-term health condition that is not typically life threatening but can cause unpleasant symptoms, such as urinary urgency, frequent urination, difficulty holding urine in, or urinary incontinence.

Anticholinergic medications are a common form of treatment for OAB. There are several types of anticholinergic medications, such as oxybutynin, solifenacin, and fesoterodine.

A doctor will consider a person’s individual circumstances before prescribing anticholinergic medications to treat OAB because they may have other health conditions that could get worse by taking them.

There are several common adverse side effects of taking anticholinergic medications, including dry mouth and headaches. A person should contact a doctor immediately if they experience symptoms of anticholinergic toxicity, such as a rapid heartbeat, seizures, and delirium.