Oxybutynin-Associated Cognitive Impairment: Evidence and Implications for Overactive Bladder Treatment.

Anticholinergic medications have long been mainstays of overactive bladder (OAB) treatment. Oxybutynin, a first-generation anticholinergic, still accounts for more than half of all OAB medication prescriptions, despite associations with impaired memory and cognition, as well as mounting evidence that it may increase the risk of incident dementia. This review details the current literature regarding oxybutynin and cognition, including evidence from preclinical, clinical, and real-world studies that show that oxybutynin binds nonspecifically to muscarinic receptors in the brain and is associated with adverse cognitive outcomes. We also discuss society recommendations to reduce use of oxybutynin and other anticholinergics to treat OAB.

Urology. 2024 Jan 29 [Epub ahead of print]

Michael B Chancellor, Alvaro Lucioni, David Staskin

Corewell Health Beaumont University Hospital, Oakland University William Beaumont School of Medicine, Royal Oak, MI. Electronic address: ., Virginia Mason Medical Center, Seattle, WA., Tufts University School of Medicine, Boston, MA.