İbrahim GÜNDOĞMUŞ, Abdulkadir KARAGÖZ, Ayhan ALGÜL

Venlafaksin kaynaklı hematüri ve prostatizm: Bir olgu sunumu

Hematüri ve prostatizm yaşam kalitesini etkileyen önemli bir tıbbi durumdur. En sık prostat hiperplazisi nedeni ile görülüyor olsa da bazı ilaçların yan etkisi olarak da görülebilmektedir. Literatürde antidepresanların ürogenital yan etkileri sık görülmesine rağmen hematüriye neden olduğuna dair raporlar nadir görülmektedir. Venlafaksin klinik pratikte majör depresif bozukluk başta olma üzere çok sayıda psikiyatrik bozuklukta kullanılan serotonin-noradrenalin geri alım inhibitörü bir antidepresandır. Güvenli ve etkili bir antidepresan olmasına rağmen bazı yan etkileri de bilinmektedir. Olgumuzda venlafaksin kullanımı sonrası hematüri ve prostatizm semptomları başlayan ve venlafaksin kesilmesi sonrası şikayetleri sonlanan 55 yaşında erkek hasta sunuyoruz. Literatürde venlafaksin, duloksetin, milnasipran ve reboksetin gibi noradrenalin mekanizması üzerinden etkili antidepresanlara bağlı prostatizm semptomları rapor edilmiş olsa da hematüri ile ilgili bir rapor bulunmamaktadır. Bildiğimiz kadarıyla vakamız venlafaksin kaynaklı hematüri olgusunun sunulduğu ilk rapordur.

Venlafaxine-Induced Hematuria and Prostatism: a Case Report

Hematuria and prostatism are important medical conditions affecting the quality of life. They are mostoften seen causally related to prostate hyperplasia but may also occur as a side effect of certainmedications. Although the urogenital side effects of antidepressants are common in the literature,reports that indicate antidepressant induced hematuria are rare. Venlafaxine, an antidepressant thatinhibits serotonin-noradrenaline reuptake, is used in clinical practice in a number of psychiatric disorders,especially in major depressive disorder. Although it is a safe and effective antidepressant, it can cause sideeffects. We present a 55-year-old man with hematuria and symptoms of prostatism starting after the useof venlafaxine that resolved after the withdrawal of venlafaxine. In the literature, symptoms of prostatismhave been reported related to antidepressants that are effective through the noradrenaline mechanism,such as venlafaxine, duloxetine, milnacipran, and reboxetine, but there are no reports on hematuria. Asfar as we know, this is the first report to present a case of venlafaxine-induced hematuria.

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Abrams P. New words for old: lower urinary tract symptoms for “prostatism”. BMJ 1994; 308:929-930. [CrossRef]
McConnell JD. The pathophysiology of benign prostatic hyperplasia. J Androl 1991; 12:356-363.
Atan A, Tuncel A. Treatment options in benign prostate hyperplasia associated with lower urinary tract symptoms. Turk J Urol 2012; 38:228-232. [CrossRef]
Cardozo L. Voiding difficulties and retention. Urogynecology. 1st ed. New York, NY: Churchill Livingstone; 1997: 305-320.
Holliday SM, Benfield P. Venlafaxine a review of its pharmacology and therapeutic potential in depression. Drugs 1995; 49:280-294. [CrossRef]
Loprinzi CL, Kugler JW, Sloan JA, Mailliard JA, LaVasseur BI, Barton DL, Novotny PJ, Dakhil SR, Rodger K, Rummans TA, Christensen BJ. Venlafaxine in management of hot flashes in survivors of breast cancer: a randomised controlled trial. Lancet 2000; 356:2059-2063. [CrossRef]
Gartlehner G, Hansen RA, Morgan LC, Thaler K, Lux L, Van Noord M, Mager U, Gaynes BN, Thieda P, Strobelberger M. Second-generation antidepressants in the pharmacologic treatment of adult depression: an update of the 2007 comparative effectiveness review [Internet] 2011.
Polimeni G, Salvo F, Cutroneo P, Nati G, Russo A, Giustini ES, Spina E. Venlafaxine-induced urinary incontinence resolved after switching to sertraline. Clin Neuropharmacol 2005; 28:247-248. [CrossRef]
Erdinc A, Gurates B, Celik H, Polat A, Kumru S, Simsek M. The efficacy of venlafaxine in the treatment of women with stress urinary incontinence. Arch Gynecol Obstet 2009; 279:343-348. [CrossRef]
Gundogmus I, Ispir M, Bakkal O, Karagoz A, Maden O, Algul A, Ebrinc S. Venlafaxine-induced prostatism: a case report. Psychiatry and Clinical Psychopharmacology 2017; 27:197-198. [CrossRef]
Naranjo CA, Busto U, Sellers EM, Sandor P, Ruiz I, Roberts EA, Janecek E, Domecq C, Greenblatt DJ. A method for estimating the probability of adverse drug reactions. Clin Pharmacol Ther 1981; 30:239-245. [CrossRef]
Akpinar A. Acute prostatism associated with milnacipran therapy: a case report. Turk Psikiyatri Derg 2009; 20:403-405.
Thor KB, Katofiasc MA. Effects of duloxetine, a combined serotonin and norepinephrine reuptake inhibitor, on central neural control of lower urinary tract function in the chloralose- anesthetized female cat. J Pharmacol Exp Ther 1995; 274:1014- 1024.
Holm KJ, Spencer CM. Reboxetine. A review of its use in depression. CNS drugs 1999; 12:65-83. [CrossRef]
Katofiasc MA, Nissen J, Audia JE, Thor KB. Comparison of the effects of serotonin selective, norepinephrine selective, and dual serotonin and norepinephrine reuptake inhibitors on lower urinary tract function in cats. Life Sci 2002; 71:1227-1236. [CrossRef]
Jost W, Marsalek P. Duloxetine: mechanism of action at the lower urinary tract and Onuf’s nucleus. Clin Auton Res 2004; 14:220-227. [CrossRef]
Abuelo JG. The diagnosis of hematuria. Arch Intern Med 1983; 143:967-970. [CrossRef]
Narayan M, Anderson G, Cellar J, Mallison RT, Price LH, Nelson JC. Serotonin transporter-blocking properties of nefazodone assessed by measurement of platelet serotonin. J Clin Psychopharmacol 1998; 18:67-71. [CrossRef]
Hergovich N, Aigner M, Eichler HG, Entlicher J, Drucker C, Jilma B. Paroxetine decreases platelet serotonin storage and platelet function in human beings. Clin Pharmacol Ther 2000; 68:435- 442. [CrossRef]