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Volume 350:2213 May 20, 2004 Number 21
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Management of Overactive Bladder

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by Ouslander, J. G.
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To the Editor: In his review of the management of overactive bladder (Feb. 19 issue),1 Dr. Ouslander states in Table 1 that cholinesterase inhibitors could theoretically contribute to detrusor overactivity, but he suggests that there is no evidence to support this association. Cholinesterase inhibitors are widely used to manage the symptoms of dementia.2

Two case series have identified patients in whom urinary incontinence developed after the initiation of treatment with cholinesterase inhibitors. In one report, among three adults with Alzheimer's disease associated with Down's syndrome, two had incontinence after starting donepezil.3 A second report documents the emergence of transient, dose-dependent . . . [Full Text of this Article]



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