ReviewInternational journal of clinical practice2008
Preserving cognitive function for patients with overactive bladder: evidence for a differential effect with darifenacin.
Review in International journal of clinical practice, 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 40 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
40 citing papers in PubMed, 1 synthesis or guideline pooled it, 141 citations in OpenAlex.
- Diagnosis and treatment of autonomic failure, pain and sleep disturbances in Parkinson's disease: guideline "Parkinson's disease" of the German Society of Neurology.Journal of neurology · 2025Guideline
- Impact of multiple low-level anticholinergic medications on anticholinergic load of community-dwelling elderly with and without dementia.Drugs & aging · 2015Trial
- Cognitive effects of oxybutynin chloride topical gel in older healthy subjects: a 1-week, randomized, double-blind, placebo- and active-controlled study.Clinical drug investigation · 2012Trial
- Evaluation of deep learning architectures for predicting ligand interactions with neurologically relevant GPCRs.Journal of cheminformatics · 2026Article
- Neuromuscular junction innervation and motor function are preserved by restoring muscarinic signaling in perisynaptic glia in ALS.iScience · 2026Article
- A Retrospective Database Analysis of Anticholinergic Burden Among Older Patients With and Without Overactive Bladder in South Korea.International neurourology journal · 2025Article
- Practical Approach to Longitudinal Neurologic Care of Adults With X-Linked Adrenoleukodystrophy and Adrenomyeloneuropathy.Neurology. Genetics · 2024Review
- Risk of dementia associated with anticholinergic drugs for overactive bladder in adults aged ≥55 years: nested case-control study.BMJ medicine · 2024Article
- Treatment of bladder dysfunction with solifenacin: is there a risk of dementia or cognitive impairment?Brazilian journal of medical and biological research = Revista brasileira de pesquisas medicas e biologica · 2022Review
- Antimuscarinic use among older adults with dementia and overactive bladder: a Medicare beneficiaries study.Current medical research and opinion · 2021Article
- Anticholinergic drugs and risk of dementia: Time for action?Pharmacology research & perspectives · 2021Article
- Drug therapies for chronic conditions and risk of Alzheimer's disease and related dementias: A scoping review.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2021Article
- Autonomic Dysfunction in Parkinson's Disease.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2020Review
- A randomized, crossover trial comparing the efficacy and safety of fesoterodine and extended-release oxybutynin in children with overactive bladder with 12-month extension on fesoterodine: The FOXY study.Canadian Urological Association journal = Journal de l'Association des urologues du Canada · 2020Article
- Oxybutynin vs Placebo for Hot Flashes in Women With or Without Breast Cancer: A Randomized, Double-Blind Clinical Trial (ACCRU SC-1603).JNCI cancer spectrum · 2020Article
- Prescribing Variation in General Practices in England Following a Direct Healthcare Professional Communication on Mirabegron.Journal of clinical medicine · 2018Article
- Anticholinergic drugs and risk of dementia: case-control study.BMJ (Clinical research ed.) · 2018Article
- Differences in Characteristics of Error-Related Potentials Between Individuals With Spinal Cord Injury and Age- and Sex-Matched Able-Bodied Controls.Frontiers in neurology · 2018Article
- CUA guideline on adult overactive bladder.Canadian Urological Association journal = Journal de l'Association des urologues du Canada · 2017Article
- Managing cognition in progressive supranuclear palsy.Neurodegenerative disease management · 2016Review
Corrections and comments
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Authors and funding
2 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAntimuscarinic agents used in the treatment of overactive bladder (OAB) differ in their potential to impair cognitive function. It is hypothesised that low brain concentrations and relatively low selectivity for the M(1) muscarinic receptor may reduce the potential for adverse central nervous system (CNS) effects with darifenacin, compared with other antimuscarinics, particularly oxybutynin.
methodsCognitive function studies evaluating darifenacin, oxybutynin, tolterodine, solifenacin and/or trospium were identified from publications databases (Medline, Biosis and Embase) and congress abstracts. Preclinical studies and randomised controlled trials in adults were reviewed.
resultsFive randomised, double-blind, multiple-dose studies of cognitive function were identified. Oxybutynin was consistently associated with cognitive deficit (four studies), whereas darifenacin did not impair cognition (three studies). These findings were supported by data from sleep/attention and EEG studies. Tolterodine data were limited to one small study with each formulation. For solifenacin and trospium, there were no human studies evaluating memory, the cognitive function most vulnerable to CNS anticholinergics.
conclusionsThere is compelling evidence of cognitive impairment with oxybutynin, whereas darifenacin stands out by demonstrating no impairment of memory or other cognitive functions in three randomised, controlled trials. This may be attributed to the differences in physicochemical properties, efflux mechanisms and relative M(1) muscarinic receptor sparing. The risk of CNS impairment is of particular concern for vulnerable populations such as the elderly (a substantial proportion of the OAB population), and CNS-compromised neurogenic bladder patients such as those with multiple sclerosis or Parkinson's disease.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.