Optimising the management of children with concomitant bladder dysfunction and behavioural disorders

Area of Science:

• Pediatric Urology
• Child and Adolescent Psychiatry
• Clinical Pharmacology

Background:

• Behavioral disorders and bladder dysfunction frequently coexist in children, complicating treatment.
• Pharmacotherapy for behavioral issues can impact bladder function, necessitating careful management.
• Understanding these interactions is crucial for effective, integrated patient care.

Approach:

• A systematic literature review adhering to PRISMA guidelines was conducted.
• A narrative approach synthesized findings from 46 studies on behavioral pharmacotherapy and bladder function.
• Included medications: stimulants, alpha-2 agonists, TCAs, SNRIs, SSRIs, and antipsychotics.

Key Points:

• Stimulants, TCAs, SNRIs, SSRIs, and antipsychotics showed varied effects on bladder function in children.
• Alpha-2 agonists had limited documented impact on bladder function.
• Six studies specifically addressed bladder management strategies in this population.

Conclusions:

• This review provides insights into predicting and managing unintended bladder effects from behavioral medications.
• A decision-making algorithm is presented to assist clinicians in treating children with co-occurring behavioral and bladder disorders.
• Integrated management strategies are essential for optimizing outcomes in pediatric patients with dual pathologies.