Solifenacin-induced acute psychosis: a case report

Area of Science:

• Pharmacology
• Neurology
• Urology

Background:

• Solifenacin is a selective muscarinic M3 receptor antagonist approved for overactive bladder (OAB) treatment since 2004.
• Its high affinity for bladder detrusor M3 receptors aids in managing OAB symptoms.
• Antimuscarinic agents, including solifenacin, possess lipophilic properties allowing potential central nervous system (CNS) penetration.

Observation:

• A case report involving a 42-year-old male patient undergoing solifenacin treatment for OAB is presented.
• The patient experienced an acute psychotic attack during the course of his treatment.
• This adverse event occurred despite the drug's known selectivity for peripheral M3 receptors.

Findings:

• The presented case suggests a potential, albeit rare, link between solifenacin use and the induction of central nervous system adverse effects.
• Psychotic symptoms were observed in the context of standard solifenacin therapy for overactive bladder.
• This highlights the importance of considering CNS side effects with antimuscarinic medications.

Implications:

• Clinicians should be vigilant for potential central nervous system side effects in patients treated with solifenacin.
• Further research may be warranted to elucidate the mechanisms underlying rare CNS adverse events associated with selective antimuscarinic agents.
• This case underscores the need for comprehensive patient monitoring during pharmacotherapy for overactive bladder.