Purpose/Rationale: Bladder problems commonly cause embarrassment and reduced quality of life (QOL), and can affect emotional health. The Multicenter Assessment of Transdermal Therapy in Overactive Bladder with Oxybutynin (MATRIX) study evaluated long-term safety and patient outcomes in adults with overactive bladder (OAB) treated with transdermal oxybutynin. This analysis compares depression symptoms among study participants, before and after treatment.

Methodology: Participants in MATRIX, an open-label, multicenter, prospective study, were treated with transdermal oxybutynin* 3.9 mg/d (new patch applied every 3-4 days) for up to 6 months. Depression symptoms were evaluated with the Beck Depression Inventory®-II (BDI-II), wherein scores >12 are associated with depression. A sufficiently large population was enrolled to allow for detection of differences across predefined subgroups. P values were based on ANCOVA (continuous variables), and McNemar's test (paired data). Results: The MATRIX population comprised 2508 women (mean age 61.4±14.7y; 41.1% working) and 369 men (mean age 69.6±13.1y; 23.6% working). The baseline mean BDI-II summary score was 10.7±9.5; 32.2% of patients scored >12. Among predefined subgroups: women scored significantly worse than men (11.0 vs 9.2; P=.0012), patients <65y worse than ≥65y, (11.9 vs 9.5; P<.0001), and women <45y worse than those ≥45 (13.4 vs 10.6; P<.0001). By study end, mean BDI-II score decreased by 2.5 (P<.0001) and the proportion of patients scoring >12 decreased to 23.2% (P<.0001). After controlling for baseline severity, women and men showed similar mean improvements (-2.6 vs. -1.6; P=.9137), as did patients <65y and ≥65y ( 3.2 vs -1.7; P=.9581), and women <45y and ≥45y (-4.5 vs -2.4; P=.5327). Conclusion: The psychological impact of OAB differs qualitatively across gender and age groups; women <45 years are more likely to report depression symptoms. Treatment with transdermal oxybutynin is associated with improvement in these symptoms across all groups.

*Oxytrol®, Watson Pharma, Corona, Calif.