Overactive Bladder in the Elderly
Clinical Overview

Reversible Incontinence

Disease Conditions spacer Medications spacer Selected References

Medications

Several medications, diseases, or other conditions can impact continence status and lead to incontinent episodes. These factors are considered to be reversible incontinence because removing or abating the factor often restores continence. General categories of medications that may contribute to incontinence include:

  • cardiovascular agents
  • diuretics
  • agents affecting the central nervous system (CNS) e.g. narcotics, sedatives, antidepressants
  • agents with anticholinergic side effects
  • miscellaneous e.g. antihistamines, decongestants

Table 1 lists specific medications that can contribute to UI and the rationale for the mechanism by which they cause UI. Dietary and social habits may cause bladder irritation due to ingestion of caffeinated, carbonated, or alcoholic beverages, resulting in UI.

Table 1: Medications that may contribute to UI (rationale based on type of UI)

Medication

Rationale

Diuretics, especially rapid-acting

Increase frequency, urgency

Anticholinergics, narcotics, Calcium channel blockers, Alpha-adrenergic agonists

Urinary retention; depress detrusor activity

Psychotropic drugs

Sedation, immobility, unsteady gait

Beta-blockers

Increase detrusor activity

Alpha-blockers

Decrease urethral resistance

Alpha-adrenergic agonists

Increase urethral resistance

Cholinesterase inhibitors

Theoretically increase detrusor overactivity by increasing acetylcholine