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 Medications for urinary incontinence?? 
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Joined: Tue Apr 24, 2007 1:09 pm
Posts: 43
Location: Alberta, Canada
Post Medications for urinary incontinence??
Hello all,

I know that our loved ones with LBD need to avoid anticholinergic drugs, but it appears that most drugs used to treat urinary incontinence are anticholinergic. Has anyone found an alternative that has been effective and safe??

I'm taking mum to the doctor tomorrow (our family physician) for a medication review. She has been experiencing increased incontinence recently and is hopeful that the doctor will be able to help.

So, does anyone have anything good to suggest??.....other than buying shares in Poise, Tena or Depends??? :lol:

Peace,
Suzee


Mon Aug 30, 2010 10:46 pm
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Joined: Fri Aug 11, 2006 1:46 pm
Posts: 4811
Location: SF Bay Area (Northern CA)
Post Re: Medications for urinary incontinence??
You can consider desmopressin (DDAVP) and botox injections in the bladder. I'm sure there's info posted here about DDAVP. Not sure about botox.


Mon Aug 30, 2010 11:57 pm
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Joined: Sun Oct 04, 2009 10:18 am
Posts: 276
Location: Washington State
Post Re: Medications for urinary incontinence??
I don't know if this qualifies as urinary incontinence, but my Mom used to get up to pee as much as 18 times a night. This was a big problem because her cognition and visual-spacial problems would cause her to miss sitting on the toilet sometimes and she would fall. Also, she couldn't get a good night's sleep. Desmopressin before bedtime took care of this. It was interesting though, when I asked the medical professionals about prescribing it they had never heard of it. She has no side effects on the desmopressin either.

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Annie, daughter of brave Marie, dx 2007 and in ALF


Tue Aug 31, 2010 10:25 am
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Joined: Fri Aug 11, 2006 1:46 pm
Posts: 4811
Location: SF Bay Area (Northern CA)
Post Re: Medications for urinary incontinence??
It's not a commonly-prescribed medication. It's primary indication is for nocturnal polyuria (multiple trips to the bathroom at night to urinate).


Tue Aug 31, 2010 10:30 am
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Joined: Tue Apr 24, 2007 1:09 pm
Posts: 43
Location: Alberta, Canada
Post Re: Medications for urinary incontinence??
Thanks for the suggestions! Mum's incontinence is happening during the day. At night she gets usually gets up a couple times. I'll do more research about the DDAVP and discuss it with the doctor today.

Again, many thanks! I don't know what I'd do without this forum. I don't post often, but I read alot of the posts, and I appreciate the wealth of information provided.

Peace,
Suzee


Tue Aug 31, 2010 11:15 am
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Joined: Sun Oct 04, 2009 10:18 am
Posts: 276
Location: Washington State
Post Re: Medications for urinary incontinence??
Hi. I'm reviving this thread because I'm wondering if anyone else's LO is taking desmopressin (DDAVP) for nocturnal polyurea? If so, I would like to compare notes. Thanks. AnnieN

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Annie, daughter of brave Marie, dx 2007 and in ALF


Tue Dec 21, 2010 11:16 am
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Joined: Fri Aug 11, 2006 1:46 pm
Posts: 4811
Location: SF Bay Area (Northern CA)
Post Re: Medications for urinary incontinence??
AnnieN,
Seems like your mom has been using this medication for over a year now. Is it still working to treat nocturnal polyuria?
Robin


Wed Dec 22, 2010 1:50 pm
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Joined: Sun Oct 04, 2009 10:18 am
Posts: 276
Location: Washington State
Post Re: Medications for urinary incontinence??
Hi Robin. The desmopressin is still working. When she has skipped a dose one day I see the effect that night. However, it isn't 100% effective. She still gets up to go at least five times a night (used to be 18) and she's a fall risk. I'm trying to figure out if there is a way to change the dosage to solve the frequent nightime urination. She takes 0.2 mg before bed. I tried 0.3 mg before bed but she had nausea to the point of vomiting. Since she goes to bed at 8:00 pm and gets up to go steadily every hour after 1:00 am I'm thinking it may be wearing off in which case giving her a dose at midnight or so may prolong the effect.

I researched all of the urinary meds that I could find (incl. EricSea's list) and it looks like this is the only one for a female with glaucoma who can't take an anticholinergic med.

Anyway, I'm talking to her PCP but she had no practical experience with desmopressin before Mom went on it. I posted because I was hoping I could talk to someone else on the forum who has experience with desmopressin. I'll probably just have to try it (after Christmas).

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Annie, daughter of brave Marie, dx 2007 and in ALF


Wed Dec 22, 2010 3:11 pm
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Joined: Fri Aug 11, 2006 1:46 pm
Posts: 4811
Location: SF Bay Area (Northern CA)
Post Re: Medications for urinary incontinence??
Annie,

Sounds like you are doing a great job with your own pharmacological experiment!

If your mom is still getting up 5 times a night, that may make things difficult for the desmopressin to work. I like your idea of giving her a bit more at midnight.

The other anticholinergic you could ask a urologist about is botox. I added that to EricSEA's list as I realized today that he hadn't included it. But it's an option for some (if you have a urologist who is game).

Robin


Wed Dec 22, 2010 9:07 pm
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Joined: Sun Oct 04, 2009 10:18 am
Posts: 276
Location: Washington State
Post Re: Medications for urinary incontinence??
Thanks for the suggestions, Robin. I looked up the Botox treatment, but my LO is quite adamant that she will have no more procedures. We had suggested a cystoscope exam early on, she refused and I respect her decision. I'm going to continue with the medication approach.

It's interesting to me that we're back trying to solve this problem when I was trying to solve this same problem a year ago. We were doing well for awhile with nocturnia polyuresis but we've come full circle. I can't complain...generally she is doing so much better than most of the 32 residents at the ALF where she moved a year ago. Many of them are no longer there. I've seen half a dozen deaths. Others had dementia that progressed faster and they have been transferred to the most demented wing. Sometimes a serious medical condition required transfer to a nursing home. Some were moved by their families for one reason or another. There's an ebb and flow of both residents and caregivers. Time passes.

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Annie, daughter of brave Marie, dx 2007 and in ALF


Thu Dec 23, 2010 11:02 pm
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Joined: Fri Aug 11, 2006 1:46 pm
Posts: 4811
Location: SF Bay Area (Northern CA)
Post Re: Medications for urinary incontinence??
Someone posted this week to LBDcaregivers about desmopressin: " it worked for a couple of nights with the frequency reducing to once or twice during the night, but then things returned to Square One."


Sat Dec 25, 2010 3:43 pm
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Joined: Fri Jan 15, 2010 9:33 pm
Posts: 3395
Location: Vermont
Post Re: Medications for urinary incontinence??
Annie - it must be so hard to see the other residents leaving and some dying where your mom is. I hope things go well today with her and that you have a nice Christmas. Big Christmas hugs, Lynn

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Lynn, daughter of 89 year old dad dx with possiblity of LBD, CBD, PSP, FTD, ALS, Vascular Dementia, AD, etc., died Nov. 30, 2010 after living in ALF for 18 months.


Sat Dec 25, 2010 3:48 pm
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Joined: Sun Oct 04, 2009 10:18 am
Posts: 276
Location: Washington State
Post Re: Medications for urinary incontinence??
Hi Lynn. Yes, it's hard when they leave and when they die. We get so attached. Many times I help them find their rooms, give them a hug, get them food or drink, or call a caregiver when there's nothing I can do. Because of State rules, the staff can't tell me why someone has left. I watch the obituaries for some sort of closure. When they die at the facility it affects my family, including my Mom. She is a retired nurse and she is aware enough that she will sit with the resident to comfort them during their last days. I feel like I should write a story about each of the residents at her facility.

Christmas is almost over. My Mom and sister were here at our house for bouillabaisse dinner. I don't think I've ever seen her eat so much. I'm thankful that this day has gone well and also that it is over. I am hopeful for the new year. Merry Christmas, everyone.

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Annie, daughter of brave Marie, dx 2007 and in ALF


Sun Dec 26, 2010 12:45 am
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Joined: Sat Jan 03, 2009 2:59 pm
Posts: 1978
Post Re: Medications for urinary incontinence??
Annie,
I am glad your Christmas was nice and you look forward to the New Year! You mention how your Mom will sit with residents in there last days that really touched my heart ! I guess her yrs as a Nurse is always with her, I think that even for many caregivers, once a caregiver always a caregiver to someone or something .

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Irene Selak


Sun Dec 26, 2010 9:02 am
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