Gabapentin for overactive bladder and nocturia after anticholinergic failure

Abstract

Fourteen of 31 patients with refractory (OAB) and nocturia improved with oral gabapentin. Gabapentin was generally well tolerated and can be considered in selective patients when conventional modalities have failed.

Enhanced Sensitivity to Afferent Stimulation and Impact of Overactive Bladder Therapies in the Conscious, Spontaneously Hypertensive Rat

“…This beneficial response on bladder function in response to ␤ 3 -adrenoceptor activation reported here in the SHR is also observed in the dog (Hicks et al, 2007) and has demonstrated translation into humans . It is noteworthy that although significant clinical interest has been generated around the use of gabapentin to treat overactive bladder through small clinical studies demonstrating a urological ben- jpet.aspetjournals.org efit of gabapentin (Kim et al, 2004;Carbone et al, 2006), to our knowledge this is the first report of efficacy in a preclinical in vivo urodynamic model. Although the exact mechanism of action for gabapentin is unclear it is suggested to work by modulation of the neuronal control of bladder function.…”

“…We also evaluated gabapentin currently under clinical development for overactive bladder (Kim et al, 2004;Carbone et al, 2006). Representative cystometrograms before and after gabapentin (30 mg ⅐ kg Ϫ1 ) are shown in Fig.…”

Investigation of the clinical efficacy and safety of pregabalin alone or combined with tolterodine in female subjects with idiopathic overactive bladder

“…10,12,13 Significantly greater baseline-adjusted improvements in MVV with standard-dose pregabalin (with or without tolterodine ER) versus tolterodine ER treatment alone further demonstrate the efficacy of pregabalin in this patient population. In addition, treatment with pregabalin also resulted in a significant reduction in urgency severity versus placebo.…”

“…11 Preliminary clinical studies evaluating subjects with neurogenic detrusor overactivity or refractory idiopathic OAB have shown that gabapentin is effective in reducing OAB symptoms and/or improving urodynamic parameters. 10,12,13 Pregabalin is another antiepileptic and analgesic medication that is similar to gabapentin in its mechanism of action.…”

LUTS treatment: Future treatment options

“…These investigators found a positive effect on symptoms and significant improvement in urodynamic parameters after treatment with gabapentin, suggesting that the effects of the drug should be explored in further controlled studies in both neurogenic and nonneurogenic DO. Kim et al 206 studied the effects of gabapentin in patients with OAB and nocturia not responding to antimuscarinics. They found that 14 of 31 patients improved with oral gabapentin.…”