Serotonergic Antidepressants and Urinary Incontinence

Abstract

Many new serotonergic antidepressants have been introduced over the past decade. Although urinary incontinence is listed as one side effect of these drugs in their package inserts there is only one report in the literature. This concerns 2 male patients who experienced incontinence while taking venlafaxine. In the present paper the authors describe 2 female patients who developed incontinence secondary to the selective serotonin reuptake inhibitors paroxetine and sertraline, as well as a third who developed this side effect on venlafaxine. In 2 of the 3 cases the patients were also taking lithium carbonate and beta-blockers, both of which could have contributed to the incontinence. Animal studies suggest that incontinence secondary to serotonergic antidepressants could be mediated by the 5HT4 receptors found on the bladder. Further research is needed to delineate the frequency of this troubling side effect and how best to treat it.

The Safety, Tolerability and Risks Associated with the Use of Newer Generation Antidepressant Drugs: A Critical Review of the Literature

“…There have also been a few reports to suggest that venlafaxine can also cause urinary incontinence. Even though the exact underlying mechanism is unknown, the action of venlafaxine on 5-HT 4 receptors appears to cause incontinence [92]. Likewise, duloxetine appears to be associated with both urinary retention and hesitancy [25].…”

Venlafaxine compromises the antinociceptive actions of gabapentin in rat models of neuropathic and persistent pain

“…However, the mechanism responsible is unclear, as 5-HT reuptake inhibitors are also thought to depress bladder emptying and have been suggested to be useful for the treatment of incontinence (de Groat 2002;Steardo and Iovino 1986). Furthermore, to our knowledge, only isolated case reports have detailed that venlafaxine may have a diuretic action (Hansen 2004;Votolato et al 2000;Cavanaugh et al 1997).…”

Sertraline-Induced Enuresis in a Prepubertal Child Resolves after Switching to Fluoxetine

“…A lthough urinary system disorders are reported as side effects of selective serotonin reuptake inhibitors (SSRIs), there have only been few cases of urinary incontinence associated with SSRIs reported in adults (Votolato et al 2000;Monji et al 2004;Ramadan et al 2006) and many fewer cases of nocturnal enuresis associated with SSRIs reported in children (Hergüner et al 2007). In addition, there has been only one case of nocturnal and diurnal enuresis reported in an adolescent on paroxetine (Toros and Erdogan 2003).…”