Detrol (Tolterodine) Side Effects Include Sleep Disturbance in Some Patients

Detrol (tolterodine) causes sleep disturbance side effects in patients who are slow drug metabolizers

One of the most common manifestations of ‘urinary incontinence’ is excessive bladder wall contraction – causing an uncontrollable urge to visit the washroom.

Antimuscarinics are the class of drugs given to patients suffering from urinary incontinence, and common ones include:

Detrol (tolterodine),
Oxybutynin, and
Fesoterodine.

Detrol (tolterodine) is processed by the drug metabolizing liver enzyme CYP2D6 into a product called 5-HMT.

5-HMT is a lot bulkier than Detrol (tolterodine) and does not cross the blood-brain-barrier into the central nervous systems. Therefore, if you carry a normal or fast CYP2D6 enzyme, most of the Detrol (tolterodine) will be converted into 5-HMT and prevents Detrol (tolterodine) from causing central nervous system side effects.

However, if you carry a slow CYP2D6 enzyme, most of the Detrol (tolterodine) remains unconverted, and is able to enter the central nervous system very easily and cause side effects that interfere with your normal REM sleep cycle.

REM Sleep is critical to normal psychological function

REM reduction greatly deteriorates sleep quality leading to sleepiness during the day. REM sleep, in average, accounts for 20-25% of total sleep, which is about 90-120 minutes in a night’s sleep.

Psychological disturbances that arise from REM deprivation includes:

Anxiety,
Irritability,
Concentration difficulties, and
Hallucinations.

Fesoterodine is also converted into 5-HMT, but independent of CYP2D6!

Fesoterodine is another drug for urinary incontinence. Like Detrol (tolterodine), it is also converted to 5-HMT. But unlike Detrol (tolterodine), the transformation of Fesoterodine does not need CYP2D6, so it doesn’t matter whether you have a fast or a slow CYP2D6 enzyme.

What does that mean for you?

If you:

Suffer from uncontrollable bladder contraction, and
Require antimuscarinic drug medication to alleviate the symptoms

You should determine the type of CYP2D6 enzyme you carry (fast, normal or slow) with GeneYouIn’sPillCheck^TM drug response test. Results from our test can assist your physician in deciding whether Detrol (tolterodine) or fesoterodine will be a better option for you and help you avoid unpleasant side effects.

Our comprehensive test will also look at a panel of other liver enzymes and can help inform your physician about how you are likely to respond to over 55 commonly prescribed medications and whether you are at risk of experience adverse side effects. If you are currently taking, or will require other medications further down the road, a single PillCheck^TM drug response test will help your physician formulate a personalized treatment strategy for you in the future.

Next steps

To learn more about how individual variations in drug response can affect the safety and efficacy of common prescription drugs you take, check out our blog “I have stars in my genome! Or how genetic variations affect my drug response.”, or follow us on Twitter and Facebook to get all the latest news and updates about how GeneYouIn is pushing personalized medicine closer to reality. As always, you can also contact us if you have any other question related to personalized medications.

Author

Ruslan Dorfman, PhD, MBA

Founder and CSO Ruslan Dorfman is a trailblazer in personalized medicine, a molecular geneticist, and technology builder. Inspired by direct interactions with Cystic Fibrosis families from all over the world, Dr. Dorfman co-founded GeneYouIn to facilitate access to advanced genetics for the general public. He managed large-scale R&D programs at Sick Kids Hospital, Toronto. He advised Bridgepoint and Mount Sinai hospitals on the implementation of personalized medicine programs. Dr. Dorfman has published thirty peer-reviewed papers on the genetics of Cystic Fibrosis and Pain.