Posted by Phillipa on October 29, 2007, at 11:45:16
In reply to Re: Not enough serotonin/Despiramine, posted by Racer on October 29, 2007, at 10:54:39
If you may have interstitial bladder problems this may help also pelvic floor excercises are recomended. Good luck. Phillipa
About Oral Medications
Some of the following oral medications are sold over-the-counter and others must be prescribed by a physician. As always, please remember that IC patients should make an extra effort to research these treatment alternatives, methods of action and the length of time required to see any results. Consultation with your personal care provider is essential.Bladder Coatings
Antidepressants: Elavil, Imiprimine
Antihistamines: Hydroxyzine (Vistaril & Atarax)
Antispasmodics: Anaspaz, Cystopas, Ditropan, Levsin, Levsinex, Urispas, Urised
Urinary Anaesthetics: Urised, Pyridium
Combination Therapies--------------------------------------------------------------------------------
Bladder Coating: ELMIRON (Sodium Pentosanpolysulfate):
In September of 1996, the IVAX Corporation received final approval from the FDA to immediately begin marketing ELMIRON®. This is the first oral drug developed and approved specifically for the treatment of IC and is now being distributed in the USA by Alza Pharmaceuticals. (DMSO is the only other FDA-approved drug for IC, but it is instilled directly into the bladder).
Over the years, ELMIRON® has been extensively discussed, studied and tested but much is still unknown about it. Dr. Lowell Parsons, a leading IC researcher who was instrumental in the development of ELMIRON®, believes it works by providing a protective coating to the bladder wall. He believes that some IC patients have a damaged or "leaky" bladder lining (epithelium). For those that do, the ELMIRON® coating appears to prevent urine, bacteria and other irritating substances from penetrating an otherwise "leaky" lining and causing inflammation in the muscle tissue.ELMIRON® is a white crystalline powder and comes in the form of capsules. The effective dose for ELMIRON® is 300 mg per day, taken either two or three times a day. ELMIRON® may take 3-6 months to work, and 6-12 months to work well by slowly rebuilding the GAG layer of the bladder (8). It may take more time to rebuild years of damage. Many doctors advise patients to give ELMIRON® at least a six month trial. Since ELMIRON® is thought to keep the bladder coated, it must be taken for the rest of the patient's life, or until a cure for IC is found.
Baker Norton conducted a very large physician use study in multiple centers across the USA. This trial enrolled 2,810 patients over a ten year period. One of the most comprehensive industry studies on IC, this may also be the longest IC treatment study to date. The data reveals that ELMIRON® patients showed a significant improvement during their course of treatment. The trial demonstrated that 42% of patients who had been treated for up to six months, and 60-62% of those treated for 24 months, had reported total, great or moderate relief of bladder pain. Of patients treated for six months, 55% had experienced a reduction in nocturia and 44% had reductions in frequency. Among patients who had no response to DMSO, more than 50% experienced moderate or better improvement when treated with ELMIRON® (8).
One of the benefits which ELMIRON® therapy can deliver is the elimination of the risk of infection that often accompanies catheterization and anesthesia. Some people experience side effects such as gastrointestinal upset or some hair loss. In some cases, your doctor may want to monitor your liver function through periodic blood tests while you are taking ELMIRON.®
Web Reference: Elmiron - USA
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Tricyclic Antidepressants: ELAVIL & TOFRANIL
Elavil® (amitryptyline) is a tricyclic antidepressant that, in low doses, is effective at relieving chronic pain by interfering with nerve activity. It is commonly prescribed for several chronic pain conditions, including irritable bowel syndrome (IBS) and fibromyalgia, two conditions that many IC patients also have. Its strength as a long-term pain management strategy, an essential part of an IC tool kit, makes it helpful in treating IC. It also may inhibit bladder spasms.
Several studies have reported a positive response with amitriptyline (9,10). Hanno (11) reports that amitriptyline was quite effective for patients who had not responded to hydrodistention and DMSO. Amitriptyline has side effects which merit consideration prior to taking it, including dry mouth, drowsiness and, for some patients, cardiac arrhythmias (irregular heart rate) and tachycardia (rapid heart rate).Other antidepressants, such as Tofranil® (imiprimine), Prozac® and a host of others, may be options for physicians to consider. Amitriptyline, however, remains the most extensively tested medication of this type for IC.
poster:Phillipa
thread:792122
URL: http://www.dr-bob.org/babble/20071027/msgs/792147.html