Confusion about measuring central nervous system effects

Current Urology Reports

Volumn 5, Issue 6, 2004, Pages 442-446

  Madersbacher, Helmut G ^a  

^a UNIVERSITY HOSPITAL INNSBRUCK   (Austria)

Author keywords

Anticholinergic Drug; Overactive Bladder; Oxybutynin; Solifenacin; Tolterodine

Indexed keywords

CHOLINERGIC RECEPTOR BLOCKING AGENT;

BRAIN; CENTRAL NERVOUS SYSTEM; COGNITION; DRUG EFFECT; ELECTROENCEPHALOGRAPHY; HUMAN; PATHOLOGY; PSYCHOMETRY; REVIEW; SLEEP; URINE INCONTINENCE;

BRAIN; CENTRAL NERVOUS SYSTEM; CHOLINERGIC ANTAGONISTS; COGNITION; ELECTROENCEPHALOGRAPHY; HUMANS; PSYCHOMETRICS; SLEEP; URINARY INCONTINENCE;

EID: 16644368541     PISSN: 15272737     EISSN: 15346285     Source Type: Journal    
DOI: 10.1007/s11934-004-0068-9     Document Type: Article

References (30)

1. Milsom I, Abrams P, Cardozo L, et al.: How widespread are the symptoms of an overactive bladder and how are they managed? A population-based prevalence study. Br J Urol Int 2001, 87:760–766.
2. Stewart W, Herzog R, Wein A, et al.: The NOBLE Program Research Team: prevalence and impact of overactive bladder in the US: Results from the NOBLE program. Neurourol Urodyn 2001, 20:403–422. DOI: 10.1002/nau.4
3. Igawa Y: Discussion: functional role of M1, M2, and M3 muscarinic receptors in overactive bladder. Urology 2000, 55(suppl 5A):47–49. Provides data on muscarinic receptor research and discusses the significance of receptor subtypes and effects on OAB pharmacotherapy. DOI: 10.1016/S0090-4295(99)00493-8
4. Schwantes U, Topfmeier P: Importance of pharmacological and physiochemical properties for tolerance of antimuscarinic drugs in the treatment of detrusor instability and detrusor hyperreflexia: chances for improvement of therapy. Int J Clin Pharmacol Ther 1999, 37:209–218. Reviews and highlights the importance of chemical structure in kinetic and dynamic properties.
5. Dmochowski RR, Appell RA: Advancements in pharmacologic management of the overactive bladder. Urology 2000, 56(suppl 6A):41–49. Cutting-edge analysis of pharmacologic therapy by leading minds in the field of urology. DOI: 10.1016/S0090-4295(00)01020-7
6. Friebe TP, Mutschler E, Lambrecht G: Muskarinrezeptor-subtypen: pharmakologische charakterisierung, molekulare struktur lokglisation, function and receptor-effector-kopplung. Pharm Z Wiss 1993, 1:3–11.
7. Hoffman BB, Lefkowitz RJ, Taylor P: Neurotransmission: the autonomic and somatic motor nervous system. In Goodman & Gilman’s The Pharmacological Basis of Therapeutics, edn 9. Edited by Hardman JG, Limbird LL. New York: McGraw-Hill; 1996:105–139.
8. Nies AS, Spielberg SP: Principle of therapeutics. In Goodman & Gilman’s The Pharmacological Basis of Therapeutics, edn 9. Edited by Hardman JG, Limbird LL. New York: McGraw-Hill; 1996:43–62.
9. Pak RW, Petrou SP, Staskin D: Trospium chloride: a quaternary amine with unique pharmacologic properties. Curr Urol Rep 2003, 4:436–440. Highlights advantages of trospiumchloride, a quaternary amine minimally metabolized, not highly protein-bound, and theoretically unable to cross the blood-brain barrier, in comparison with other standard anticholinergic treatment. DOI: 10.1007/s11934-003-0023-1
10. Fricker G, Miller DS: Modulation of drug transporters at the blood-brain barrier. Pharmacology 2004, 70:169–176. An excellent review of knowledge about the active transport proteins including ABC and organic anion transporters, which function at the blood-brain barrier. DOI: 10.1159/000075545
11. Van de Waterbeemd H, Camenisch G, Folkers G, et al.: Estimation of blood-brain barrier crossing of drugs using molecular size and shape, and H-bonding descriptors. J Drug Target 1998, 6:151–155. DOI: 10.3109/10611869808997889
12. Mahar Doan KM, Humphreys JE, Webster LO, et al.: Passive permeability and P-glycoprotein-mediated efflux differentiate central nervous system (CNS) and non-CNS marketed drugs. J Pharmacol Exp Ther 2000, 303:1029–1037.
13. Bendayan R, Lee G, Bendayan M: Functional expression and localization of P-glycoprotein at the blood-brain barrier. Microsc Res Tech 2002, 57:327–349. DOI: 10.1002/jemt.10088
14. Zhang Y, Han H, Elmquist WF, Miller DW: Expression of various multidrug resistance-associated protein homologues in brainmicrovessel endothelial cells. Brain Res 2000, 876:148–153. DOI: 10.1016/S0006-8993(00)02628-7
15. Lorico A, Rappa G, Finch RA, et al.: Disruption of the murine MRP (multidrug resistance protein) gene leads to increased sensitivity to etoposide (VP-16) and increased levels of glutathione. Cancer Res 1997, 57:5238–5242.
16. Valsecia ME, Malgor LA, Espindola JH, et al.: New adverse effect of oxybutynin: “night terror” [Letter]. Ann Pharmacother 1998, 32:506. DOI: 10.1345/aph.17257
17. Appell R: Clinical efficacy and safety of tolterodine in the treatment of overactive bladder: a pooled analysis. Urology 1997, 50(suppl 6A):90–99. DOI: 10.1016/S0090-4295(97)00599-2
18. Guay DR: Tolterodine, a new antimuscarinic drug for treatment of bladder overactivity. Pharmacotherapy 1999, 19:267–280. DOI: 10.1592/phco.19.4.267.30943
19. Diefenbach K, Donath F, Maurer A, et al.: Randomized, doubleblind study of the effects of oxybutynin, tolterodine, trospium chloride and placebo on sleep in healthy young volunteers. Clin Drug Invest 2003, 23:395–404. DOI: 10.2165/00044011-200323060-00003
20. Diefenbach K, Arold G, Wollny A, et al.: The influence of anticholinergics used in incontinence on sleep in healthy volunteers aged 50 years and older. Abstract presented at the ICS/IUGA Annual Meeting. Paris: August 25–27, 2004. From these two studies, it is obvious that there already are differences between young healthy volunteers and healthy volunteers over the age of 50 years; in the young volunteers only, oxybutynin changed their sleep structure and in healthy volunteers over the age of 50 years, oxybutynin and tolterodine, not trospumchloride, change sleep structure.
21. Perry EK, Kilford L, Lees AJ, et al.: Increased Alzheimer pathology in Parkinson’s disease related to antimuscarinic drugs. Ann Neurol 2003, 54:235–238. DOI: 10.1002/ana.10639
22. Pietzko A, Dimpfel W, Schwantes U, Topfmeier P: Influences of trospium chloride and oxybutynin on quantitative EEG in healthy volunteers. Clin Pharmacol 1994, 47:337–343.
23. Todorova A, Vonderheit-Guth B, Dimpfel W: Effects of tolterodine, trospium chloride, and oxybutynin on the central nervous system. J Clin Pharmacol 2001, 41:636–644. Compares the potential CNS adverse effects of tolterodine, oxybutynin, trospium chloride, and placebo in a randomized, single-blind, parallel-group with qEEG study. Oxybutynin caused a significantly greater number of EEG changes than did tolterodine or trospium. DOI: 10.1177/00912700122010528
24. Herberg KW, Füsgen I: Effect of trospium chloride, oxybutynin-HCl, and propiverine-HCl on traffic related performance with respect of safety. Geriatrie Forschung 1997, 7:77–83.
25. Donnellan CA, Fook L, Mc Donald P, et al.: Oxybutynin and cognitive dysfunction. BMJ 1997, 315:1363–1364.
26. In T’Veld BA, Kwee-Zuiderwijk WJ, Van Puijenbroek EP, et al.: Neuropsychiatrische bijwerkingen toegeschreven aan her gebruik van oxybutynin. Ned Tijschr Geneeskd 1998, 142:590–592.
27. Malone-Lee JG, Walsh JB, Maugourd MF: Tolterodine: a safe and effective treatment for older patients with overactive bladder. J Am Geriatr Soc 2001, 49:700–770. DOI: 10.1046/j.1532-5415.2001.49144.x
28. Edwards KR, O’Connor J: Risk of delirium with concomitant use of tolterodine and acetylcholinesterase inhibitors [Letter]. Jag S 2002, 50:1165–1166. DOI: 10.1046/j.1532-5415.2002.50281.x
29. Moore AR, O’Keefe ST: Drug-induced cognitive impairment in the elderly. Drugs Aging 1999, 15:15–28. DOI: 10.2165/00002512-199915010-00002
30. Brickenkamp R, Zillner E: The d2 Test of Attention (d2). In Testkatalog 2000/2001. Testzentrale, Göttingen, Bern: Hogrefe-Verlag; 2000:60.