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The Impact of Polypharmacy on Management of Lower Urinary Tract Symptoms in Parkinson’s Disease

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Abstract

Lower urinary tract (LUT) symptoms are a common presentation of autonomic dysfunction in Parkinson’s disease (PD). Symptoms significantly impact quality of life and are associated with worsening of motor symptoms and increased risk for falls. Different medical co-morbidities can often contribute to LUT symptoms, and a thorough evaluation therefore becomes essential. The effects of medications used for Parkinson’s disease and other co-existing medical co-morbidities on LUT symptoms is often underestimated. Treatment options include behavioural therapy, oral agents such as antimuscarinic and beta-3 receptor agonist agents, botulinum toxin and neuromodulation. The first-line oral agents cause adverse effects that may exacerbate pre-existing Parkinson’s disease-related symptoms. Furthermore, these oral agents can interact with other medications used in Parkinson’s disease, and the challenges posed by interactions on pharmacological effects and metabolism are discussed. Knowledge about drug interactions can help in effective management of such patients and mitigate the risks for developing adverse effects.

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Authors and Affiliations

  1. Department of Neurology, Amrita Institute of Medical Sciences, Kochi, India

    Udit Saraf

  2. Department of Clinical and Movement Neuroscience, Faculty of Brain Science, National Hospital for Neurology and Neurosurgery, Queen Square, London, UK

    Amit Batla

  3. Department of Neurology, Sakura Medical Center, Toho University, Sakura, Japan

    Ryuji Sakakibara

  4. Department of Uro-Neurology, The National Hospital for Neurology and Neurosurgery, Queen Square, UCLH NHS Foundation Trust, London, UK

    Jalesh N. Panicker

  5. Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London, London, United Kingdom

    Jalesh N. Panicker

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  1. Udit Saraf
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  2. Amit Batla
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  4. Jalesh N. Panicker
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Correspondence to Udit Saraf.

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The authors Udit Saraf, Amit Batla, Ryuji Sakakibara and Jalesh N Panicker declare that they have no conflicts of interest that might be relevant to the contents of this manuscript. The authors declare that there are no additional disclosures to report.

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Saraf, U., Batla, A., Sakakibara, R. et al. The Impact of Polypharmacy on Management of Lower Urinary Tract Symptoms in Parkinson’s Disease. Drugs Aging 40, 909–917 (2023). https://doi.org/10.1007/s40266-023-01060-2

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