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.

Cleveland State University

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.

Proposed biological reasons for development of mental disorders in IC patients

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

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.

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