Treatment-emergent incontinence with lithium

Area of Science:

• Nephrology
• Pharmacology
• Urology

Background:

• Lithium carbonate is a common mood stabilizer used in treating bipolar disorder.
• Urinary incontinence is a prevalent condition, particularly among female patients.

Observation:

• A study observed 23 female outpatients undergoing lithium carbonate treatment.
• Four patients (17%) exhibited significant urinary or urgency incontinence during treatment.

Findings:

• Lithium-induced urinary incontinence was noted in 17% of female outpatients.
• Symptoms improved with anticholinergic drugs (e.g., oxybutynin), imipramine, or reduced lithium doses.
• A potential mechanism suggests lithium disrupts the bladder's cholinergic-adrenergic balance.

Implications:

• Clinicians should monitor for urinary incontinence in patients on lithium carbonate.
• Pharmacological interventions can effectively manage lithium-induced incontinence.
• Further research into the neurochemical mechanisms of lithium's effect on bladder function is warranted.