Literature DB >> 16225528

Pharmacodynamic effects of darifenacin, a muscarinic M selective receptor antagonist for the treatment of overactive bladder, in healthy volunteers.

Gary G Kay1, Keith A Wesnes.   

Abstract

OBJECTIVE: To evaluate the pharmacodynamic effects of darifenacin (a muscarinic M(3) selective receptor antagonist) and dicyclomine (an M(1) selective receptor antagonist) in healthy male volunteers. SUBJECTS AND METHODS: In this double-blind, four-way crossover study, 27 healthy men (aged 19-44 years) were randomized to receive darifenacin 7.5 mg or 15 mg once daily, dicyclomine 20 mg four times daily or matching placebo. Each 7-day treatment period was separated by a 7-day washout. Multiple assessments of cognitive function, quantitative electroencephalogram (EEG) recordings, salivation, visual nearpoint, heart rate and heart rate variability were made on day 7 in each treatment period.
RESULTS: Compared with placebo, neither dose of darifenacin affected cognitive function, whereas dicyclomine impaired performance on five of the 12 variables 2 h after dosing; simple reaction time (P = 0.009), speed of numeric (P = 0.012) and spatial (P = 0.048) working memory, and speed (P = 0.04) and sensitivity (P = 0.03) of picture recognition. These cognitive changes were accompanied by slowing of the EEG for dicyclomine. Darifenacin showed no clinically relevant effect on EEG. Darifenacin 7.5 and 15 mg once daily did not differ from placebo in effects on visual nearpoint, heart rate or heart rate variability. By contrast, dicyclomine significantly increased the maximum visual nearpoint, decreased heart rate and increased heart rate variability, relative to placebo. Both agents decreased salivary flow rate vs placebo. Treatment-related adverse events were comparable in all groups, the most common being dry mouth; none led to treatment discontinuation.
CONCLUSIONS: Darifenacin did not affect cognitive, cardiac or visual function in healthy volunteers, a profile that may reflect its relative M(3) receptor selectivity and M(1)/M(2) sparing properties.

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Year:  2005        PMID: 16225528     DOI: 10.1111/j.1464-410X.2005.05745.x

Source DB:  PubMed          Journal:  BJU Int        ISSN: 1464-4096            Impact factor:   5.588


  17 in total

Review 1.  Muscarinic receptors: their distribution and function in body systems, and the implications for treating overactive bladder.

Authors:  Paul Abrams; Karl-Erik Andersson; Jerry J Buccafusco; Christopher Chapple; William Chet de Groat; Alison D Fryer; Gary Kay; Alan Laties; Neil M Nathanson; Pankaj Jay Pasricha; Alan J Wein
Journal:  Br J Pharmacol       Date:  2006-06-05       Impact factor: 8.739

2.  Anticholinergics and central nervous system effects: are we confused?

Authors:  David R Staskin; Edward Zoltan
Journal:  Rev Urol       Date:  2007

Review 3.  Treatment of Overactive Bladder in the Elderly Female: The Case for Trospium, Oxybutynin, Fesoterodine and Darifenacin.

Authors:  Scott C McFerren; Alex Gomelsky
Journal:  Drugs Aging       Date:  2015-10       Impact factor: 3.923

4.  Differential Prescribing of Antimuscarinic Agents in Older Adults with Cognitive Impairment.

Authors:  Scott Martin Vouri; Mario Schootman; Seth A Strope; Stanley J Birge; Margaret A Olsen
Journal:  Drugs Aging       Date:  2018-04       Impact factor: 3.923

Review 5.  Blood-brain barrier permeation and efflux exclusion of anticholinergics used in the treatment of overactive bladder.

Authors:  Michael B Chancellor; David R Staskin; Gary G Kay; Bobby W Sandage; Michael G Oefelein; Jack W Tsao
Journal:  Drugs Aging       Date:  2012-04-01       Impact factor: 3.923

Review 6.  Antimuscarinic drugs: review of the cognitive impact when used to treat overactive bladder in elderly patients.

Authors:  Dustin Pagoria; R Corey O'Connor; Michael L Guralnick
Journal:  Curr Urol Rep       Date:  2011-10       Impact factor: 3.092

Review 7.  Antimuscarinics for the treatment of overactive bladder: understanding the role of muscarinic subtype selectivity.

Authors:  Karin Glavind; Michael Chancellor
Journal:  Int Urogynecol J       Date:  2011-04-06       Impact factor: 2.894

Review 8.  Preserving cognitive function for patients with overactive bladder: evidence for a differential effect with darifenacin.

Authors:  G G Kay; U Ebinger
Journal:  Int J Clin Pract       Date:  2008-08-11       Impact factor: 2.503

9.  Anticholinergic drug use for overactive bladder in Sweden: a nationwide pharmacoepidemiological study.

Authors:  Daniel Altman; Fredrik Granath; Anders Mattiasson; Christian Falconer
Journal:  Int Urogynecol J Pelvic Floor Dysfunct       Date:  2009-07-28

10.  Contribution of the M3 muscarinic receptors to the vasodilator response to acetylcholine in the human forearm vascular bed.

Authors:  Teresa M Attinà; James J Oliver; Lorenzo S Malatino; David J Webb
Journal:  Br J Clin Pharmacol       Date:  2008-04-10       Impact factor: 4.335

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