IC UPDATE, no good news here

As though having IC is not bad enough now I’ve read that taking some medications long term is being reported as causing an increase in mental clouding….sometimes called dementia.

I’ve taken elavil for about 30 years and I feel sluggish all the time and concerned about my mind.! I’ll start tapering it down while I start something recommended called PEAORA POLY 500 dietary supplement. (sold on the IC website.) This has been used in Europe for years for pain management. I’ve started with one tablet daily to start and will taper back on the Elavil, which is kind of scary, but I’m hopeful.

I’ve added this information from the IC optimist website.

For interstitial cystitis and overactive bladder patients struggling with intense urinary frequency and urgency, physicians often prescribe anticholinergic medications such as Amitryptiline (Elavil), imipramine (Tofranil) or Nortryptiline (Pamelor), Oxybutynin (Ditropan, Oytrol) or Tolteradine (Detrol). Unfortunately, their use has now been linked to cognitive decline and dementia in some patients who use it daily for long periods of time.

New research from the United Kingdom studied the medical records of 58,769 people with dementia and 225,574 without dementia, all 55 years or older. They found that long-term, daily use (3 years or longer) of certain anticholinergic medications were associated with a 50% higher risk of dementia, including: bladder medications for overactive bladder, antidepressants, antipsychotic, anti-Parkinson’s and epilepsy drugs. The study found no significant risks for two other types of medications also used by IC patients (anthistamines and skeletal muscle relaxants)  although the number of patients using them were small. The authors strongly suggested that anticholinergic drugs should be prescribed with caution in middle-aged and older people.

We asked Dr. Robert Evans for his thoughts on this issue. “We have always known that elderly patients can develop mental status changes, confusion and even dementia if exposed to anticholinergics which is why so many of us prefer to use Mirabegron for pts with overactive bladder” he said. “I rarely use anticholinergics in patients with IC as I do not think they help decrease frequency.  The reason is that IC patients void frequently because of pain not because of overactivity. These meds will not decrease voiding frequency since they do not help with pain.  I especially want to avoid them on patients who are on other drugs with anticholinergic activity such as antihistamines, tricyclics or gabapentin.” 

Thankfully self-help strategies can also help! Many IC patients have learned that their frequency and urgency is often triggered by certain foods and beverages.  If you are struggling with symptoms and still drinking coffees, sodas, green teas, black teas, there is hope. You could feel much better in a relatively quick period of time by modifying your diet and eliminating these risk foods. It’s certainly worth trying, right?

Spring/Summer 2019 IC Optimist Magazine

You can find a more extensive discussion of this topic in the Spring/Summer 2019 IC Optimist, the ICN Member magazine. Learn more here! 

References:

  1. Coupland C, et al. Anticholinergic Drug Exposure and the Risk of Dementia. JAMA Intern Med. Published online June 24, 2019. Accessed June 30, 2019 – https://jamanetwork.com/journals/jamai nternalmedicine/fullarticle/2736353

This new study is going to challenge the already challenging treatment of IC, now we can’t take the medications that allowed us to improve our quality of life with IC.

50% is a impressive number!

4 thoughts on “IC UPDATE, no good news here

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