Lara Utku INCE, LALE GÖNENİR ERBAY, SÜHEYLA ÜNAL

Urinary retention in male patient associated with aripiprazole

Urinary retention and / or voiding difficulty are a rare side effect caused by the second generation antipsychotics. Aripiprazole has a lower incidence of adverse effects than other second generation antipsychotics (SGA) and aripiprazole can be used as an alternative treatment on patients who have urinary retention depending on antipsychotic use. Although there are limited data in literature about the effect of aripiprazole on urinary retention, a case was encountered urinary retention with the use of antidepressants and aripiprazole together. Also there is only one case in the literature about urinary retention occurred with aripiprazole. Our case emerged urinary retention with the addition of aripiprazole while under treatment of paroxetine. Patient's complaints have stopped with the discontinuation of aripiprazole and never emerged under treatment of paroxetine and risperidon e. We aimed to contribute this case because there is limited data in literature about this subject. As a result, adrenergic, cholinergic, serotonergic, dopaminergic and histaminergic pathways have role on control of micturition but it is not clear that on which pathway aripiprazole acts on urination. However there is no symptom of urinary retention after stopping aripiprazole and adding risperidone, shows that there is a different mechanism associated with voiding in this case. Additional studies need to be done to clarify the mechanism

PDF

___

Muench J, Hamer AM. Adverse effects of antipsychotic medications. Am Fam Physician. 2010;81(5):617-22.

Sokolski KN, Brown BJ, Melden M. Urinary retention following repeated 2004;38(5):899-900. Ann Pharmacother.

Kwon JS, Jang JH, Kang D-H, Yoo SY, Kim YK, Cho SJ; APLUS study group. Long-term efficacy and safety of aripiprazole in patients with schizophrenia, schizophreniform disorder, or schizoaffective disorder: 26-week prospective study. Psychiatry Clin Neurosci. 2009;63(1):73-81.

Goodnick PJ, Jerry JM. Aripiprazole: profile on efficacy and safety. Expert Opin Pharmacother. 2005;3(12):1773-81.

Saddichha S. Aripiprazole in a Patient Susceptible to Urinary Side Effects of Antipsychotics. Isr J Psychiatry Relat Sci. 2007;44(1):74-5.

Chiang C-L, Liu C-C. Micturition difficulty associated with aripiprazole: report of 2 cases. J Clin Psychopharmacol. 2011;31(1):128-9.

Padala PR, Sadiq HJ, Padala KP. Urinary obstruction with citalopram and aripiprazole combination in an elderly patient. J Clin Psychopharmacol. 2006;26(6):667-8.

Hsu W-Y, Chang T-G, Chiu N-Y. Aripiprazole associated urine retention in a male schizophrenia patient. Gen Hosp Psychiatry. 2013;35(6):680.

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(2):239-45.

Andersson K-E. Treatment of overactive bladder: other drug mechanisms. Urology. 2000;55(5):51-7.

Michel MC, Vrydag W. Alpha1-, alpha2- and beta-adrenoceptors in the urinary bladder, urethra and prostate. Br J Pharmacol. 2006;147:88-119.

Ramage AG. The role of central 5-hydroxytryptamine (5-HT, serotonin) receptors in the control of micturition. Br J Pharmacol. 2006;147:120-31.

Zorn BH, Montgomery H, Pieper K, Gray M, Steers WD. Urinary incontinence and depression. J Urol. 1999;162(1):82-4.

Englisch S, Fritzinger M, Zink M. Urinary retention during combined treatment of postpsychotic depression with duloxetine and olanzapine. Clin Neuropharmacol. 2008;31(5):307-9.

de Groat WC, Yoshimura N. Pharmacology of the lower urinary tract. Annu Rev Pharmacol Toxicol. 2001;41:691-721.

Dobrek L, Juszczak K, Wyczólkowski M, Thor PJ. Current management and future perspectives of overactive bladder (OAB) pharmacotherapy. Acta Pol Pharm. 2011;68(6):807-21.

Yoshimura N, Mizuta E, Yoshida O, Kuno S. Therapeutic effects of dopamine D1/D2 receptor agonists on detrusor hyperreflexia in 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine-lesioned parkinsonian cynomolgus monkeys. J Pharmacol Exp Ther. 1998;286(1):228-33.

Thor KB. Targeting serotonin and norepinephrine receptors in stress urinary incontinence. Int J Gynaecol Obstet. 2004;86:38-52.

Yoshimura N, Groat WC de. Neural Control of the Lower Urinary Tract. Int J Urol. 1997;4(2):111-25.