26 March 2017
- Use of bladder drug oxybutynin has risen 31 per cent in the five years
- But evidence now suggests the drug's side effects include dementia
- Doctors warned last night it should no longer be used because of the risks
Evidence suggests that the drug oxybutynin comes with sever side effects including cognitive decline and dementia
Thousands of people who take a common bladder drug are at risk of developing dementia, experts warned last night.
Use of oxybutynin, recommended by the NHS as a primary medication for urinary incontinence, has risen by 31 per cent in five years.
The pills help stop the muscle spasms that cause overactive bladder syndrome, a problem experienced by six million in Britain.
But evidence now suggests the drug comes with severe side effects, including cognitive decline and dementia.
Doctors last night warned the drug should no longer be used at all because of the risks.
People who take the pills for more than three years were 54 per cent more likely to develop dementia within a decade, research suggests. Some 1.7million prescriptions for oxybutynin were issued in England in 2015, making up more than a quarter (26 per cent) of drugs prescribed for urinary incontinence.
The prescriptions have steadily increased since 2010, when 1.3million were issued.
Professor Marcus Drake, a urologist at Bristol University, said: ‘Frankly my view is that this drug should not be prescribed at all. It is not well tolerated, it is not as effective and it carries these risks.’ He said other, safer drugs are available, but doctors often turn to oxybutynin because it is so cheap.
The drug costs just 4p per pill, taken between two and four times a day. Alternative bladder medicines cost up to £1 per tablet.
Professor Drake said: ‘Oxybutynin is the one of the class that we should avoid when it comes to dementia and memory risk. But it’s very cheap, so instead of focusing on the safety there is a balance that has arisen where doctors try it and if there are no immediate problems they keep using it.’
Professor Drake was speaking last night ahead of new data being presented today at the European Association of Urology conference in London, which warns oxybutynin now makes up 27 per cent of prescriptions for overactive bladders in the US.
The drug, which costs just 4p per pill, is taken between two and four times a day. Its use has risen 31 per cent in the last five years
Dr Daniel Pucheril of Henry Ford Hospital in Detroit, who led the research, said: ‘Doctors need to look closely at the levels of prescribing. Despite evidence of side effects, physicians are not commonly checking for cognitive effects in those using these medications.’
Figures from the online information centre NHS Digital show that prescribing patterns in the UK are almost identical to those in the US. The drug is one of the most-used of a class of drugs called anticholinergics, a broad group of medications which include antidepressants, antihistamines, sleeping pills and antipsychotics.
Anticholinergics are well known to have an impact on cognition, increasing the risk of falls and memory problems.
But Professor Drake said oxybutynin is more dangerous than similar drugs, because it has a small molecule size, meaning it more easily penetrates the brain.
When it is inside the brain, it binds to a receptor that plays a key role in the higher central nervous system, which can reduce cognition and bring about long-term effects. A study of 3,400 over-65s by the University of Washington, published in the JAMA medical journal in January 2015, found that people who took anticholinergics for three years were 54 per cent more likely to later develop dementia.
A fifth of the participants in the Washington study took anticholinergics for bladder problems, and the authors picked out oxybutynin as one of two drugs of particular concern.
They concluded: ‘Given the devastating consequences of dementia, informing older adults about this potentially modifiable risk would allow them to choose alternative products.’