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Duloxetine: the long awaited drug treatment for stress urinary incontinence
Author(s) -
Orme Susie,
Ramsay Ian
Publication year - 2005
Publication title -
the obstetrician and gynaecologist
Language(s) - English
Resource type - Journals
eISSN - 1744-4667
pISSN - 1467-2561
DOI - 10.1576/toag.7.2.117.27070
Subject(s) - duloxetine , medicine , placebo , urinary incontinence , adverse effect , stress incontinence , duloxetine hydrochloride , urology , alternative medicine , pathology
Duloxetine is a newly licensed drug treatment for stress urinary incontinence in women. It is a combined noradrenaline and serotonin reuptake inhibitor and its adverse‐effect profile can be attributed to its pharmacological action. It has clinically important interactions with other drugs including warfarin and antidepressants. Duloxetine is believed to act by increasing sphincter activity in the storage phase of the micturition cycle. A meta‐analysis of phase II and III double‐blind placebo controlled trials involving 1913 women (aged 22‐83 years) with stress urinary incontinence symptoms demonstrated a highly significant difference in reduction of diary reported incontinence episodes per week, mean increase in time between voids and quality of life. However, we feel that first‐line therapy remains physiotherapy. The availability of duloxetine in primary care should not deny referral and assessment for surgery for those women who would benefit.