Imperial College Healthcare NHS Trust, Charing Cross Hospital, Department of Neurosciences, London, UK.
Expert Opin Drug Saf. 2010 Nov;9(6):905-15. doi: 10.1517/14740338.2010.501793.
The use of anticholinergic medication in bladder dysfunction such as overactive bladder syndrome (OAB) is widespread. However, the benefits and risks of anticholinergics in multiple sclerosis (MS) are unclear because in MS the damage to normal urinary function is both more diffuse and increases with disease progression, and the risk of CNS side effects is higher.
The pathophysiology of urinary dysfunction in MS and the efficacy and side effects of anticholinergics is assessed. The review analyzed randomized controlled trials and observational studies using anticholinergics involving persons with a confirmed diagnosis of MS having urinary symptoms. Finally a pragmatic approach to managing urinary symptoms in MS is discussed.
The published data provide limited evidence for the efficacy of anticholinergics in MS. The complexity of treating urinary symptoms in the context of other therapies and the changing neurological background seen in MS is comprehensively analyzed.
Anticholinergics could be helpful in particular phases of MS. However, there is inadequate evidence currently available on the use of anticholinergics in MS, and further research on the management of the MS neuropathic bladder is warranted.
抗胆碱能药物在膀胱功能障碍（如膀胱过度活动症）中的应用非常广泛。然而，在多发性硬化症（MS）中，抗胆碱能药物的益处和风险尚不清楚，因为在 MS 中，正常的尿功能受损更为广泛，并随着疾病的进展而增加，而且 CNS 副作用的风险更高。
评估了 MS 中尿功能障碍的病理生理学，以及抗胆碱能药物的疗效和副作用。该综述分析了涉及有明确 MS 诊断且有尿症状的患者的使用抗胆碱能药物的随机对照试验和观察性研究。最后，还讨论了一种实用的管理 MS 中尿症状的方法。
已发表的数据为抗胆碱能药物在 MS 中的疗效提供了有限的证据。全面分析了在其他治疗背景下治疗尿症状的复杂性，以及 MS 中所见的不断变化的神经学背景。
抗胆碱能药物在 MS 的特定阶段可能会有所帮助。然而，目前关于 MS 中使用抗胆碱能药物的证据不足，需要进一步研究 MS 神经源性膀胱的管理。
