International Journal of Scientific and Research Publications, Volume 3, Issue 1, January 2013 1 ISSN 2250-3153 www.ijsrp.org Comparative Study of Solifenecin Alone Versus Solifenecin with Duloxetine in Patients of Overactive Bladder Anusha Vohra * , Sanjay Khanna ** , Pratap Shankar *** , Rakesh Verma **** , R. K. Dixit ***** * Assistant Professor Pharmacology Mahatma Gandhi Medical College Jaipur ** Assistant Professor Pharmacology Hind Institute of Medical Sciences Barabanki *** Ph.D Pharmacology King George’s Medical University Lucknow **** Lecturer Pharmacology R.I.M.S Safai Etawah ***** Professor Pharmacology King George’s Medical University Lucknow Abstract- Aims and Objective- Present study was undertaken to see and compare the effect of solifenacine alone and solifenacine with duloxetine therapy in patients with overactive bladder. Material Methods:- The study was done on the patients with overactive bladder. The patients were diagnosed clinically by the physician and urologists. Before enrolling in the study each patient was asked to give a written consent. The outcome measures were evaluated in form of reducing the frequency, urgency and other clinical symptoms. Simultaneously we also measured the quality of life of the patients using accepted scale. Results and Conclusion:- Present study showed that addition of duloxetine with solifenasin has definitely produced better clinical improvement in patients as well as the quality of life was also imporved. Though minor side effects increased by this addition but overall quality of life was better in patients on combination therapy as compared to the single solifenasin treatment. Index Terms- Overactive bladder, Quality of life, Duloxetine, Solifenasin I. INTRODUCTION veractive bladder (OAB) is defined as a “symptom syndrome suggestive of lower urinary tract dysfunction” characterized by “urgency, with or without urge incontinence, usually with frequency and nocturia (Wein AJ. et al., 2002; Abrams P, et al. 2002) [1,2]. Typically occurring without a recognizable underlying etiologic factor, OAB is a diagnosis of exclusion, intuitively considered to be related to detrusor overactivity (DO). OAB has significant negative impact on the quality of life (QOL). As such, QOL issues encompass physical, psychological and social functioning, overall life satisfaction, perception of health status, and pain (Liberman JN.et al., 2001; Chancellor M. B., et al. 2008; Abrams P, et al. 2000) [3,4,5]. The World Health Organization (WHO) estimated that urinary incontinence affects nearly 200 million people worldwide (Stewart WF.et al., 2003)[6]. OAB is a common condition that affects millions of people worldwide and OAB-associated urge urinary incontinence (UUI, ‘wet’ OAB) is especially prevalent in older women (Rovner and Wein 2002)[7]. OAB occurs as a result of abnormal and involuntary contractions of the detrusor muscle in the bladder, which is embedded by muscarinic receptors (M 2 and M 3 subtypes). Stimulation of M 2 and M 3 receptors by acetylcholine causes bladder contractions that lead to urination (Chu FM.et al., 2006; Erdem N.et al., 2006)[8,9]. Normally, the detrusor muscle remains at rest as the bladder is filled by urine (filling phase). However, it contracts during the filling phase in patients with OAB. Therefore, muscarinic receptor antagonists (antimuscarinic agents) are considered the mainstay of pharmacologic treatment for OAB. Solifenacin belongs to a class of medications called anticholinergics. It is a bladder-selective, muscarinic (M 1 and M 3 ) receptor antagonist. Solifenacin works by relaxing the bladder muscles to prevent urgent, frequent, or uncontrolled urination, by competitively inhibiting acetylcholine from binding to cholinergic receptors. It reduces smooth muscle tone in the bladder, allowing the bladder to retain larger volumes of urine and reducing the number of micturition, urgency and incontinence episodes. As it is highly receptor (M 3 ) specific, it has lesser incidence of side effects like dry mouth and constipation (Cardozo L.et al., 2004; Smulders RA.et al., 2004; Ohtake A.et al., 2004) [10,11,12]. Duloxetine, the dual serotonin (5-HT)/ nor epinephrine (NE) reuptake inhibitor, modulates lower urinary tract function through selective inhibition of 5-HT and NE reuptake sites. It works centrally at Onuf’s nucleus to increase activity of the pudendal nerve. It facilitates sphincter activity during urine storage but not during voiding, maintaining the bladder-sphincter synergy (Norton PA.et al., 2004) [13]. Treatment planning for patients with OAB must be based on clinical evidence of efficacy for the drugs chosen, individual patient psychological illness, and an assessment of the probable benefits of treatment versus its associated adverse effects. The present study aimed at evaluating better treatment with more efficacy, better safety profile and positive impact in quality of life in patients of OAB. The objective of this study was to assess and compare the effects of solifenacin alone versus solifenacin with duloxetine in patients suffering from over active bladder. II. MATERIALS AND METHODS Study design O