Central pain conditions respond to central nervous system neuromodulating drugs, including serotonin and noradrenaline reuptake inhibitors (SNRIs), which are a class of antidepressants that have also shown therapeutic effect in IC patients. Serotonergic pathways are linked to the regulation of voiding function and depression. Low levels of serotonin are seen in individuals diagnosed with depression, and is also associated with loss of bladder control.

Serotonin and Interstitial Cystitis

Over-the-counter medications for pain relief have not been studied in randomized, placebo-controlled settings. The bioflavonoid (plant chemical) quercetin, in an open-label study, showed that most IC patients showed some improvement in outcome measures. Calcium glyerophosphate helped to reduce food-related flares. Phenazopyridine hydrochloride, a urinary analgesic, provides short-term relief.

Pharmaceutical Interventions for IC

It is believed that the that central nervous system is involved in the painful symptoms of IC, as well as anxiety, depression, and insomnia.  The characteristic symptoms of central pain conditions include multifocal pain, fatigue, insomnia, and a higher rate of comorbid mood disorders.

Cleveland State University

Depression and panic disorder are significantly more common in individuals with pelvic pain conditions. Anxiety and depression may be more difficult to treat in patients with urological pain syndromes, even with psychotropic medications.

Interstitial Cystitis and Mental Health

Chuang, YC., Weng, SF., Hsu, YW. et al. Increased risks of healthcare-seeking behaviors of anxiety, depression and insomnia among patients with bladder pain syndrome/interstitial cystitis: a nationwide population-based study. Int Urol Nephrol 47, 275–281 (2015). https://doi.org/10.1007/s11255-014-0908-6

Increased risks of healthcare-seeking behaviors of anxiety, depression and insomnia among patients with bladder pain syndrome/interstitial cystitis: a nationwide population-based study

Clemens, J. Q., Brown, S. O., & Calhoun, E. A. (2008). Mental Health Diagnoses in Patients With Interstitial Cystitis/Painful Bladder Syndrome and Chronic Prostatitis/Chronic Pelvic Pain Syndrome: A Case/Control Study. The Journal of Urology, 180(4), 1378–1382. doi:10.1016/j.juro.2008.06.032 


Mental Health Diagnoses in Patients With
Interstitial Cystitis/Painful Bladder Syndrome and Chronic
Prostatitis/Chronic Pelvic Pain Syndrome: A Case/Control Study

Psychological symptoms may be the consequences of trauma caused by bladder pain, urgency, frequency, and nocturia. Individuals may have a reduced quality of life due to the chronic nature of the disorder and increased anxiety surrounding its' low rate of remission. IC symptoms by nature interfere with daily activity, interpersonal relationships, and sexual function, and such consequences could increase emotional distress.

Proposed psychosocial reasons for development of mental disorders in IC patients

A flow chart depicting first through sixth lines of treatment, based on American Urological Association guidelines.

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