E-Posters-Litoxetine (LTX), a Novel Highly Specific Agonist/Antagonist SSRI Is a Safe and Well Tolerated Treatment for Mixed Urinary Incontinence

Litoxetine (LTX), a Novel Highly Specific Agonist/Antagonist SSRI Is a Safe and Well Tolerated Treatment for Mixed Urinary Incontinence - Dudley Robinson, MD, FRCOG

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Pdf Summary

Litoxetine (LTX) is a novel drug that acts as a Selective Serotonin Reuptake Inhibitor (SSRI) and a Multifunctional Serotonin Agonist Antagonist (MSAA) in the treatment of mixed urinary incontinence. Serotonin plays a role in controlling bladder function, with inhibitory effects on detrusor muscle activity and excitatory effects on the urethral sphincter. Animal studies have shown that LTX can increase urethral pressure, sphincter muscle tone, and bladder capacity.<br /><br />Two randomized controlled trials (RCTs) were conducted to evaluate the efficacy, safety, and tolerability of LTX in subjects with urinary incontinence. RCT1 involved 198 female subjects with mixed urinary incontinence and evaluated fixed dosages of LTX at 10, 20, and 40 mg BID over a 12-week period. RCT2 included 84 subjects with urinary incontinence and utilized a dose titration approach, starting with LTX up to 30 mg BID with the option of dose reduction to 20 mg if needed.<br /><br />Overall, LTX was found to be safe and well-tolerated in both RCTs. Common adverse events reported were nausea and there were no deaths. In RCT1, additional adverse drug reactions included headache, asthenia/fatigue, hypertension/increased blood pressure, vomiting, diarrhea, and rash. The safety evaluation in RCT2, which included dose titration, did not show any differences compared to placebo.<br /><br />Psychiatric evaluation in RCT2 revealed minimal levels of depression and anxiety in subjects receiving LTX, with no reported suicidal behavior or ideation. Poor sleep was reported by a portion of subjects in both LTX and placebo groups.<br /><br />Overall, LTX reduced incontinence events and improved patient-reported outcomes in subjects with mixed urinary incontinence. The drug was well-tolerated, and tolerability appeared to improve with dose escalation. These findings were presented at the EAU and ICS conferences in 2019.

Keywords

Litoxetine

LTX

Selective Serotonin Reuptake Inhibitor

SSRI

Multifunctional Serotonin Agonist Antagonist

MSAA

mixed urinary incontinence

bladder function

urethral sphincter

RCT