Anticholinergic medication for the unstable bladder: prospective trials of imipramine/propantheline versus penthienate and oxybutynin versus penthienate

Abstract

A comparison was made of three drug regimens: imipramine (Tofranil)/propantheline, oxybutynin (Ditropan) and penthienate bromide (Monodral). Two comparative trials were performed in prospective studies, using a randomization and cross-over design. All the drugs were found to improve the urinary symptoms and urodynamic changes associated with the unstable bladder, but penthienate was shown to be more effective than imipramine/propantheline. Its effect on the unstable bladder was equivalent to that of oxybutynin. Side-effects were common and most common with oxybutynin. However, the inability of these drugs to prevent the uninhibited detrusor contractions of the unstable bladder consistently and objectively was demonstrated.