An exploratory study for bladder dysfunction in atypical antipsychotic-emergent urinary incontinence

Area of Science:

• Urology
• Psychiatry
• Pharmacology

Background:

• Atypical antipsychotics are associated with urinary incontinence (UI).
• The mechanisms underlying antipsychotic-emergent UI require further investigation.

Purpose of the Study:

• To analyze urodynamic findings in patients experiencing UI while on atypical antipsychotics.
• To elucidate the mechanisms of antipsychotic-emergent UI.

Main Methods:

• An exploratory study involving eight patients (schizophrenia/psychotic disorders) on atypical antipsychotic monotherapy (risperidone, olanzapine, clozapine) with UI.
• Urodynamic studies were conducted on all recruited patients.

Main Results:

• 75% of patients (6/8) exhibited abnormal urodynamic findings.
• Common findings included detrusor overactivity (DO) with or without detrusor-sphincter dyssynergia (DSD), and hypoactive detrusor with nonrelaxing sphincter.
• Urinary symptoms reported were urgency, enuresis, and straining; two patients had significant postvoid residual urine.

Conclusions:

• Bladder dysfunction observed in antipsychotic-emergent UI mirrors that seen in neurological disorders.
• Urinary complaints in patients on antipsychotics necessitate systematic evaluation and management protocols typically used for neurological conditions.