Year : 2005  |  Volume : 47  |  Issue : 2  |  Page : 130-

Reboxetine-induced urinary hesitancy


Suresh Borade, Mahesh Bhirud, Kranti Kadam 
 Department of Psychiatry, Lokmanya Tilak Municipal Medical College and Lokmanya Tilak Municipal General Hospital, Sion, Mumbai 400022, India

Correspondence Address:
Suresh Borade
Department of Psychiatry, Lokmanya Tilak Municipal Medical College and Lokmanya Tilak Municipal General Hospital, Sion, Mumbai 400022
India




How to cite this article:
Borade S, Bhirud M, Kadam K. Reboxetine-induced urinary hesitancy.Indian J Psychiatry 2005;47:130-130


How to cite this URL:
Borade S, Bhirud M, Kadam K. Reboxetine-induced urinary hesitancy. Indian J Psychiatry [serial online] 2005 [cited 2021 Oct 27 ];47:130-130
Available from: https://www.indianjpsychiatry.org/text.asp?2005/47/2/130/55964


Full Text

Sir,

One of the troublesome side-effects of tricyclic anti­depressants is urinary hesitancy due to their anticholinergic effects. [1]

Reboxetine, the only selective noradrenaline reuptake inhibitor, is an effective and well-tolerated antidepressant. Since it has low affinity for muscarinic, cholinergic receptors, [2] anticholinergic side-effects such as urinary retention or hesitancy are not expected.

However, some patients on reboxetine (2-4 mg/day) complain of urinary hesitancy. A peripheral noradrenergic mechanism termed 'pseudoanticholinergic syndrome' may be responsible for this side-effect. [3]

Tamsulosin, an alpha-1A receptor antagonist, is recommended for reboxetine-induced urinary hesitancy. [4],[5] Therefore, the following precautions should be taken while a patient is on reboxetine:

Enquire about any history of urinary complaints beforehand.In elderly patients, titrate the dose upwards gradually.During follow-up visits, ask patients whether they have any urinary hesitancy.If reboxetine-induced urinary hesitancy does set in, then rather than withdrawing reboxetine, a trial of capsule tamsulosin (available locally as Urinat) can be started in a single dose of 0.4 mg half-an-hour after dinner every day.

References

1Sadock BJ, Sadock AV. Tricyclics and tetracyclics. In: Cancro R (ed). Synopsis of psychiatry. 9th ed. Philadelphia: Lippincott Williams& Wilkins; 2003:1125-31.
2Sadock BJ, Sadock AV. Reboxetine. In: Cancro R (ed). Synopsis of psychiatry. 9th ed. Philadelphia: Lippincott Williams& Wilkins; 2003:1092-3.
3Stahl SM. Classical antidepressants, serotonin selective reuptake inhibitors, and noradrenergic reuptake inhibitors. In: Essential psychopharmacology. 2nd ed. New Delhi: Cambridge University Press; 2003:199-243.
4Dermyttenaire K, Huygens R, Van Buggenhout R. Tamsulosin as an effective treatment for reboxetine associated urinary hesitancy. Int Clin Psychopharmacol 2001;16:353-5.
5Kasper S, Wolf R. Successful treatment of reboxetine induced urinary hesitancy with tamsulosin. Eur Neuropsychopharmacol 2002;12:119-22.