The Utility of Amitryptiline in Female Overactive Bladder Patients with Nocturia

Purpose: Anticholinergics suppress the muscarinic receptors in the bladder smooth muscle and, increase the level of urine storage. Their side effects include dry mouth, dry eyes, constipation, drowsiness, and tachycardia. These adverse effects limit the dosing and often decrease patient compliance. This study examined the effect of amitryptline as one of the firstline treatments for overactive bladder patients with nocturia. Materials and Methods: Between June 2005 and June 2006, a prospective randomized study was carried out on 45 female patients with an overactive bladder. The mean age was 57.6 years and the patients were treated with doxazosin (Group I), doxazosin with tolterodine (Group II), doxazosin with amitriptyline (Group III). All 45 (Group I: 15, Group II: 15, Group III: 15) were followed up for 4 weeks. The treatment efficacy was measured using the 3 days of voiding diaries. Results: The actual number diurnal voids showed considerable improvement after treatment (p 0.05). The actual number of nightly voids improved after treatment (p 0.05). There was no difference in the total voiding volume, functional bladder capacity, nocturnal bladder capacity index, nocturia index between pre-treatment and post-treatment in each group (p>0.05). Conclusions: There are some enhanced effects with the actual number of diurnal voids and the actual number nightly voids in patients treated with doxazosin with amitriptyline. Therefore, amitripyline is helpful as a firstline treatment in female overactive bladder patients with nocturia. (Korean J Urol 2008;49:733-738) 󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏