The medical treatment of overactive bladder, including current and future treatments.

Introduction: Oveactive bladder (OAB) is a common condition that affects patients' quality of life. The role of antimuscarinics and future treatments in the management of this bothersome condition is reviewed.

Areas Covered: The current literature on the efficacy, suitability and safety of current and future treatments is reviewed based on a search of Medline/Pubmed for relevant articles published in English between 1980 and 2010.

Expert Opinion: Currently, antimuscarinic drugs are the cornerstone of OAB treatment; clinically recommended doses of these agents decrease the ability of the bladder to contract during the storage phase and so increase cystometric bladder capacity. In general, these agents are safe and have mild adverse effects. There is also evidence that, despite having different tolerability profiles, available drugs are well tolerated compared with placebo. Antimuscarinic agents, as a class, have similar efficacy. They offer substantial help in the alleviation of OAB symptoms, providing significant improvement to quality of life. Investigation to provide pharmacological alternatives whenever antimuscarinic drugs do not provide symptomatic relief or cause intolerable side effects is intense. Beta-adrenergic agents may be the next pharmacologic agents for OAB. However, many other areas of research may soon provide new pharmacological agents for OAB treatment.