Psychotropic Drugs and Their Effects on Lower Urinary Tract Function: an Update

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• 作者：Amanda S. J. Chung ; Janice N. C. Cheng ; Vincent Tse
• 刊名：Current Bladder Dysfunction Reports
• 出版年：2016
• 出版时间：September 2016
• 年：2016
• 卷：11
• 期：3
• 页码：258-265
• 全文大小：300 KB
• 刊物主题：Urology/Andrology;
• 出版者：Springer US
• ISSN：1931-7220
• 卷排序：11

文摘

A psychotropic drug is defined as a drug “capable of affecting the mind, emotions, and behavior; denoting drugs used in the treatment of mental illnesses” (Medical Dictionary for the Health Professions and Nursing 2012). Use of these drugs can lead to urinary dysfunction, but it is often difficult to delineate whether urinary dysfunction is a direct/indirect result of drug use or secondary to an unrelated concurrent condition. This situation can therefore result in diagnostic or management dilemmas for urologists, psychiatrists, and primary care physicians. This article reviews the literature published in the last 3 years, and provides an update on the desirable and undesirable effects of psychotropic drugs on lower urinary function. Duloxetine is an antidepressant with efficacy in the treatment of stress urinary incontinence. In addition, duloxetine and desipramine have been proposed in the treatment of overactive bladder. Laboratory research into potential therapies which target the role of neurotrophins in lower urinary tract function is in progress. Narcotic analgesia, several antipsychotics, antidepressant, anticonvulsant, and stimulant medications are associated with urinary retention. Several antidepressants have been associated with nocturnal enuresis. Furthermore, ketamine is known to induce storage symptoms, with reduction in bladder capacity. Lower urinary tract symptom (LUTS)-causing drugs are associated with polypharmacy, and elderly patients are particularly susceptible to adverse events due to pharmacotherapy. Awareness of psychotropic drug side effects and rationalization of their use is important to avoid undesirable outcomes. When patients with bothersome LUTS who are on psychotropic drugs fail to benefit from simple first-line treatments for LUTS, clinicians should be mindful that the psychotropic drug may indeed be the cause of LUTS and seek to liaise with the patient’s psychiatrist or primary care physician to discuss reasonable alternatives.KeywordsPsychotropic drugsLower urinary tract symptomsUrinary retentionUrinary incontinenceAntipsychotic agentsAntidepressive agents