Efficacy and Safety of Selective Serotonin Reuptake Inhibitor (SSRI) in Overactive Bladder Patients
Condition: Overactive Bladder
MeSH terms: Urinary Bladder, Overactive
Study type: Interventional
Phase: Phase 4

Summary: 
      The urologic literature suggests that there is an association between a variety of
      psychiatric disorders and incontinence. Most notably, depression is found in a significant
      percentage of patients with urinary incontinence. Depression also occurs in other conditions
      associated with urinary urge incontinence, such as aging and dementia, and in neurologic
      disorders such as normal pressure hydrocephalus. Correction of some neurologic disorders
      eliminates both depression and urge incontinence. Although chronic medical disorders such as
      urge incontinence may lead to depression, an alternative hypothesis is that these two
      conditions share a common neurochemical pathogenesis. Lowering monoamines such as serotonin
      and noradrenaline in the central nervous system (CNS) leads to depression and urinary
      frequency and a hyperactive bladder in experimental animals. Thus, depression may not only be
      the result of persistent urinary incontinence, but individuals with altered CNS monoamines
      could manifest both depression and an overactive bladder. The latter condition may lead to
      urge incontinence, urinary frequency, urgency, or enuresis. Uncovering further evidence for
      such a linkage could serve as the basis for the development of genetic markers and novel
      therapeutic interventions for these two conditions.

      In this study, the investigators will evaluate the efficacy and safety of SSRI on OAB
      patients who does not respond to the antimuscarinic agents.
    

Detailed description: 
      -  3-month, prospective, open-label, comparative trial

        -  Primary Objectives:

             -  To investigate the changes of OAB symptoms in patients who did not showed
                therapeutic benefits after 3 months of treatment with antimuscarinic agents and who
                then treated with SSRI (escitalopram) for 3 months.

        -  Secondary Objectives

             -  To investigate the change of patient perception of urgency and bladder condition

             -  To investigate the change of patient perception of quality of life

             -  To investigate the change of psychologic parameters

             -  To investigate the patient perception of treatment benefit

             -  To find the predictive factors of patients who respond to the 3 month-treatment
                with escitalopram

             -  To explore the efficacy of escitalopram on the tolerability and safety
    

Intervention name(s): Selective serotonin reuptake inhibitors; Antimuscarinics
Intervention type(s): Drug; Drug
Intervention description(s): escitalopram 10mg once daily for 3 months; Antimuscarinics for 3 months
Other intervention name(s): Lexapro®
Intervention MeSH terms: Selective Serotonin Reuptake Inhibitors; Serotonin; Muscarinic Antagonists
Allocation: Non-Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Overactive bladder; SSRI; Antimuscarinics