In new study of drugs used to treat overactive bladder, trospium chloride appeared to have the least impact on sleep, according to German researchers.

“Overactive-bladder symptoms frequently occur in elderly people,” senior investigator Dr. Ivar Roots commented to AMN Health. However, drugs commonly used to relieve symptoms may also have central nervous system (CNS) effects, he noted. Trospium is a drug that does not cross the blood-brain barrier.

As reported in the medical journal BJU International, Roots of Dr. R. Pfleger GmbH, Bamberg, and colleagues investigated the effects of placebo and a single dose of oxybutynin, tolterodine and trospium chloride on 12 healthy men and women between 51 and 65 years old. None of the subjects had a history of sleep disturbances.

Sleep studies showed that compared to placebo, oxybutynin and tolterodine altered REM sleep patterns, but the effects of trospium were comparable to those of placebo. None of the agents appeared to have any effect on cognitive and subjective sleep variables.

Trospium may be superior because of fewer CNS effects, continued Roots. Therefore, if overactive bladder patients develop side effects with other drugs, “trospium should be tried before stopping drug treatment altogether.”

More attention should be paid to sleep disturbance as a possible adverse effect after drug intake, he added. For the patient, it may be a trade-off - “either he is disturbed during sleep by overactive-bladder symptoms or he suffers from non-refreshing sleep because of [drug] side effects.”

Dr. R. Pfleger GmbH funded the trial as part of its clinical development program for trospium chloride.

SOURCE: BJU International, February 2005.