Antidepressants for Urinary Incontinence
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This medicine is usually taken as pills or liquid (orally).
How It Works
Duloxetine is an antidepressant called a "selective serotonin and norepinephrine reuptake inhibitor." It changes how the brain uses certain brain chemicals. How it helps with bladder control is not yet known.
Imipramine is a tricyclic antidepressant, but it has anticholinergic side effects. This means that it relaxes the smooth muscle of the bladder. It also causes the muscles at the bladder neck to contract.
Why It Is Used
Duloxetine may be prescribed for stress incontinence.
Imipramine may be prescribed for:
- Urge incontinence .
- Stress incontinence.
- Mixed urge and stress incontinence.
How Well It Works
Duloxetine rarely cures stress incontinence. But it can reduce the number of times you leak urine. People taking duloxetine also felt it improved their quality of life.1
Imipramine is not a well-studied incontinence treatment. It is not known as a highly effective treatment for urinary incontinence. But it may be worth trying if other medicines don't work or if they cause side effects.
All medicines have side effects. But many people don't feel the side effects, or they are able to deal with them. Ask your pharmacist about the side effects of each medicine you take. Side effects are also listed in the information that comes with your medicine.
Here are some important things to think about:
- Usually the benefits of the medicine are more important than any minor side effects.
- Side effects may go away after you take the medicine for a while.
- If side effects still bother you and you wonder if you should keep taking the medicine, call your doctor. He or she may be able to lower your dose or change your medicine. Do not suddenly quit taking your medicine unless your doctor tells you to.
Call 911 or other emergency services right away if you have:
- Trouble breathing.
- Swelling of your face, lips, tongue, or throat.
Call your doctor right away if you have:
- Thoughts of suicide.
- Dark urine or light-colored stool.
- Nausea and vomiting.
- Yellow eyes and skin (jaundice).
- Upper right abdominal pain .
Common side effects include:
- Diarrhea or constipation.
- Trouble sleeping.
- Cough or sore throat.
Call your doctor if you have:
- Thoughts of suicide.
- Vision problems.
- Problems with urination, including difficulty beginning to urinate, a urine stream that stops and starts, a weak urine stream, a need to strain while urinating, or a sense that the bladder is not empty after urination.
- Confusion, delirium, or hallucinations.
- A dry mouth for more than 2 weeks.
Common side effects include:
- Dizziness or drowsiness.
- Dry mouth, nose, throat, and eyes.
- Weight gain.
FDA Advisory. The U.S. Food and Drug Administration (FDA) has issued an advisory on antidepressant medicines and the risk of suicide. The FDA does not recommend that people stop using these medicines. Instead, a person taking antidepressants should be watched for warning signs of suicide. This is especially important at the beginning of treatment or when the doses are changed.
See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)
What To Think About
Imipramine can make drowsiness worse when it is combined with alcohol or other medicines that make you sleepy. These include cold and allergy medicines. Check with your doctor before taking any other medicines with imipramine, including medicine you can get without a prescription. If you are feeling sleepy, don't drive or do anything else that could be dangerous to your or other people.
Imipramine may cause your skin to be more sensitive to sunlight. When you are taking this medicine:
- Stay out of the sun, if possible.
- Wear long pants, long-sleeved shirts, and hats, if possible.
- Use sunscreen with an SPF that your doctor recommends.
- Call your doctor if you have a severe reaction after being in the sun.
Dry mouth is common when you take imipramine. To help with dry mouth, you can chew sugarless gum, suck on sugarless candy, or melt ice in your mouth. If you continue to have problems with dry mouth after a couple weeks, call your doctor. Dry mouth can lead to tooth decay and gum disease.
Medicine is one of the many tools your doctor has to treat a health problem. Taking medicine as your doctor suggests will improve your health and may prevent future problems. If you don't take your medicines properly, you may be putting your health (and perhaps your life) at risk.
There are many reasons why people have trouble taking their medicine. But in most cases, there is something you can do. For suggestions on how to work around common problems, see the topic Taking Medicines as Prescribed.
Advice for women
If you are pregnant, breast-feeding, or trying to get pregnant, do not use any medicines unless your doctor tells you to. Some medicines can harm your baby. This includes prescription and over-the-counter medicines, vitamins, herbs, and supplements. And make sure that all your doctors know that you are pregnant, breast-feeding, or planning to get pregnant.
Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.
Last Revised: September 13, 2010
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