Actas Urológicas Españolas
versión impresa ISSN 0210-4806
VELA NAVARRETE, R.; PEREZ MARTINEZ, F.C.; RAMIREZ PEREZ DEL YERRO, M. y GONZALEZ ENGUITA, C.. Duloxetine and others tricyclic antidepressants: pharmacodynamic effects on lower urinary tract. Actas Urol Esp [online]. 2003, vol.27, n.10, pp.751-766. ISSN 0210-4806.
INTRODUCTION: During years the pharmacology of the lower urinary tract function has been presided by the protagonism of the autonomic nervous system and its components, simpathetic and parasimpathetic. Recent investigations proved a greater complexity of mictional dynamics, attributing a more important role to the central nervous system (SNC), to the striated sphincter and to the afferent arc, offering a new opportunity to the Tricyclic Antidepressants (T.A.), reason for this general review. MATERIAL AND METHODS: Using as reference the work of the First Consultation on Incontinence (Montecarlo, 1999), the previous and later publications about T.A. have been reviewed, including experimental (isometric and "in vivo" studies) and clinical studies, investigating on pharmacological evidences, mechanism of action, tolerance and other effects of T.A. RESULTS: Only a reduced group of T.A. have been submitted to experimental evaluations and employeed in clinical trials. The recent works on Duloxetine have waked up a special interest by their pharmacological potential. CONCLUSIONS: New knowledge on the peripheral and central control of the continence-miction dynamic offer new pathways for the treatment with T.A., whose effectiveness and tolerance are reviewed.
Palabras clave : Tricyclic Antidepressant; Urinary incontinence; Lower urinary tract; Duloxetine.