Psychotic Disorder Induced by Oxybutynin

Abstract

Anticholinergic agents are muscarinic receptor antagonists that suppress the activity of the acetylcholine system in the brain. Some of these agents also increase the concentration of dopamine in the synaptic cleft, which may result in psychotic symptoms. Oxybutynin is an antimuscarinic drug that may have adverse effects on the CNS, including memory impairment, confusion, delirium and hallucinations in elderly patients. To date, several case reports have been published about the association between oxybutynin and psychotic symptoms in elderly subjects, but we were unable to find any case reports describing oxybutynin-induced psychotic disorders in young people. Here we report on two patients, a 7-year-old boy and a 21-year-old man, who developed a brief psychotic disorder that may have been caused by oxybutynin. The first patient was kept under observation with vital functions supported but no medication. All his psychotic symptoms regressed and his general condition improved. The second patient was treated with olanzapine 10 mg/day. His psychotic symptoms resolved within 3 weeks. Our two case reports provide evidence that oxybutynin may induce psychotic disorders, and in younger patients.

Oxybutynin addiction amongst prisoners: two case reports

“…Studies on the abuse of anticholinergic drugs have focussed mainly on patients with Parkinson's disease and psychiatric disease diagnosis. The first case study on oxybutynin addiction in the relevant literature was carried out by Gulsun et al, 7 followed by other research. 8,9 In the present study, unlike the former ones, the participants were inmates who stated that the underlying reason for oxybutynin addiction was lack of alcohol and drugs.…”

Antimuscarinic Drugs: Review of the Cognitive Impact When Used to Treat Overactive Bladder in Elderly Patients

“…In a randomized, double-blind, double-dummy study involving 150 healthy patients (≥60 year), Kay et al [22] reported that a 3-week treatment with oxybutynin ER resulted in significant memory impairment on delayed recall performance in the NameFace Association test that was comparable to cognitive aging of 16 years. Hallucinations and episodes of psychosis also have been reported with oxybutynin, even in young patients [24]. Several other published studies have further established the CNS effects of oxybutynin.…”

Managing Urinary Incontinence in Patients with Dementia: Pharmacological Treatment Options and Considerations

“…Immediate-release oxybutynin was associated with a deterioration in the misplaced objects test, a test of delayed recall [71]. Oxybutynin has been associated with impairment of cognition in therapeutic doses in case reports from clinical practice [56,60,72,73]. A single observational study assessed the cognitive effects of propiverine and revealed no change in the Fostein's MMSE score (baseline 27/30) in 221 older adults with overactive bladder over 12 weeks [74].…”