Tamsulosin as an effective treatment for reboxetine-associated urinary hesitancy

Reboxetine, the only selective noradrenaline reuptake inhibitor, is an effective and well tolerated antidepressant. Although reboxetine has no anticholinergic effects, urinary hesitancy/retention is occasionally observed in male patients. A peripheral noradrenergic mechanism of action has been suggested as being responsible for this side-effect. To test this hypothesis, the alpha1A-receptor antagonist, tamsulosin, was administered to six male patients who developed urinary hesitancy in association with reboxetine treatment. The evolution of the severity of the urinary hesitancy was assessed using the American Urological Association (AUA) symptom index and a (dis)satisfaction item score. Tamsulosin (0.4 mg/day) rapidly ameliorated symptoms in all patients. After 1 week of tamsulosin treatment, total AUA symptom index score and the (dis)satisfaction item score had decreased significantly (P = 0.04 and P = 0.007, respectively). Furthermore, tamsulosin was well tolerated in all patients. These results suggest that tamsulosin is an effective treatment for reboxetine-associated urinary hesitancy.