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Thread: ques about oxybutlin-SCI nurse? :)

  1. #1
    Senior Member
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    ques about oxybutlin-SCI nurse? :)

    I read an article recently about a study of oxybutlin?s side effects, and the mention of it possibly causing dementia. I?d been taking it for a while and promptly stopped. I mentioned this to my doctor, who said he?d never heard of this study before?.but then said there?s a possibility this might be true because oxybutlin does the opposite action of altzheimer?s medication. He talked so fast I couldn?t understand the explanation. Can anyone clarify this for me?
    "courage is fear that has said its prayers"

  2. #2
    There is an association between taking anticholinergic medications (not only oxybutynin, but a whole slew of drugs, including common over the counter drugs like benadryl (diphenhydramine)) and dementia. This means that older people (average age 73 in the study) who took large amounts of anticholinergic medications for long periods of time were more likely to develop dementia, especially Alzheimers.

    In those who used the most anticholinergic medications the chances of getting alzheimers was about 1.7 times higher than normal.

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4358759/


    According to alz.org, the risk of developing alzheimers in the remainder of your lifetime if you are 65 years old is 9% in men and 17% in women.

    Assuming you are a woman (based on your username) and that you're 65 (I can see by your profile you are not, but that's who the study was done on), you would have a risk of 29% of developing alzheimers instead of a 17% risk if you did not take oxybutynin.

    So you and your doctor have to decide whether the benefits of taking the medication outweigh the increased risk of dementia.


    For myself, I was on a similar medication that I chose not to take because it made me too foggy headed. There are a couple of options for bladder control either with anticholinergic medications that do not cross the blood brain barrier (and so presumably would not cause this increased risk fo dementia) and at least one of a different class. They tend to be more expensive and not as effective at controlling bladder spasms as oxybutynin, but for me being mentally sharp was imperative and worth a little worse bladder control. Personally I am not concerned about the dementia causing aspects of these kind of medications and occasionally i do take benadryl or similar allergy meds. 65 is like 30 years away for me and I don't plan on living to 65 in any case, much less longer than that to develop dementia.


    IMO it's not entirely clear that this study done on 70 year olds is can necessarily be extrapolated to someone of your age. It would be logical to assume that use of anticholinergic medications before you turn 65 increases your chance of dementia as well, but that's not what the study looked at, so we can't be sure. It's also possible that something is confounding the result and that people who are genetically predisposed to develop alzheimers tend to have diseases that require treatment with anticholinergics (depression, overactive bladder, etc).

  3. #3
    I did some research on this and it exacerbates older people who already have dementia. There is no indication that in younger, healthier people it causes dementia. I am not a medical professional so you can take my opinion for what it is worth.

  4. #4
    Because of this possible side effect, among others, my father takes trospium (brand name Sanctura) instead for his neurogenic bladder. It does not cross the blood brain barrier, so it does is unlikely to have similar side effects.

    It works well for my father.

    My Dad's neuro-urologist uses trospium for most of her SCI patients.

  5. #5
    Senior Member
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    wow! you've given me a lot to think about. thanks!
    one question-
    why do you think that you won't live to be 65?

    Quote Originally Posted by funklab View Post
    There is an association between taking anticholinergic medications (not only oxybutynin, but a whole slew of drugs, including common over the counter drugs like benadryl (diphenhydramine)) and dementia. This means that older people (average age 73 in the study) who took large amounts of anticholinergic medications for long periods of time were more likely to develop dementia, especially Alzheimers.

    In those who used the most anticholinergic medications the chances of getting alzheimers was about 1.7 times higher than normal.

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4358759/


    According to alz.org, the risk of developing alzheimers in the remainder of your lifetime if you are 65 years old is 9% in men and 17% in women.

    Assuming you are a woman (based on your username) and that you're 65 (I can see by your profile you are not, but that's who the study was done on), you would have a risk of 29% of developing alzheimers instead of a 17% risk if you did not take oxybutynin.

    So you and your doctor have to decide whether the benefits of taking the medication outweigh the increased risk of dementia.


    For myself, I was on a similar medication that I chose not to take because it made me too foggy headed. There are a couple of options for bladder control either with anticholinergic medications that do not cross the blood brain barrier (and so presumably would not cause this increased risk fo dementia) and at least one of a different class. They tend to be more expensive and not as effective at controlling bladder spasms as oxybutynin, but for me being mentally sharp was imperative and worth a little worse bladder control. Personally I am not concerned about the dementia causing aspects of these kind of medications and occasionally i do take benadryl or similar allergy meds. 65 is like 30 years away for me and I don't plan on living to 65 in any case, much less longer than that to develop dementia.


    IMO it's not entirely clear that this study done on 70 year olds is can necessarily be extrapolated to someone of your age. It would be logical to assume that use of anticholinergic medications before you turn 65 increases your chance of dementia as well, but that's not what the study looked at, so we can't be sure. It's also possible that something is confounding the result and that people who are genetically predisposed to develop alzheimers tend to have diseases that require treatment with anticholinergics (depression, overactive bladder, etc).
    "courage is fear that has said its prayers"

  6. #6
    Good explanations. I am not sure there is much more to add.
    ckf
    The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

  7. #7
    Quote Originally Posted by jennypenny View Post
    wow! you've given me a lot to think about. thanks!
    one question-
    why do you think that you won't live to be 65?
    Glad to help where I can.

    With regard to living to 65, it has nothing to do with SCI. I just plan to spend my life, rather than save it, before I'm too old to care for myself.

  8. #8
    LOL Funklab. I think all us old guys thought the same. Once you're past 65 and spent your life thinking you'd never make it. It's not too bad. I'm like you, spend it to it's fullest. Still do and will never stop.

  9. #9
    Quote Originally Posted by Patrick Madsen View Post
    LOL Funklab. I think all us old guys thought the same. Once you're past 65 and spent your life thinking you'd never make it. It's not too bad. I'm like you, spend it to it's fullest. Still do and will never stop.
    And if i make it and life is still worth living, that's fine too. Just not gonna change my habits at 35 years old based on a risk of changes in my cognition that might happen at 80.

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