An Additive Mix? Acute Urinary Retention in a Patient With Benign Prostatic Hyperplasia Treated With Suboxone, Lurasidone, and Trazodone

Kahn, Benjamin; Boazak, Mina; Ragazino, James; Sineath, R. Craig; Kapral, Troy

doi:10.1176/appi.focus.20180007

Cited by 2 publications

(3 citation statements)

References 34 publications

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“…It has also been reported that trazodone may cause inhibition in muscle contraction by blocking 5-HT 2a receptors, preventing serotonin entry (18). Control of micturition is under both central and peripheral activity, and 5-HT 2a receptors are one of the central receptors promoting external urinary sphincter contraction through activity at sacral plexus resulting in bladder filling (18). Trazodone's antagonism on 5-HT 2a receptors might have a central effect on micturition by inhibiting external urinary sphincter contraction and causing voiding impairment.…”

Section: Discussionmentioning

confidence: 97%

“…In clinical practice, voiding impairment due to trazodone might be seen not only as a result of anticholinergic activity but also as a blockage of α 1 receptors causing inhibition of internal sphincter contraction. It has also been reported that trazodone may cause inhibition in muscle contraction by blocking 5-HT 2a receptors, preventing serotonin entry (18). Control of micturition is under both central and peripheral activity, and 5-HT 2a receptors are one of the central receptors promoting external urinary sphincter contraction through activity at sacral plexus resulting in bladder filling (18).…”

Section: Discussionmentioning

confidence: 99%

“…It is also known that tricyclic antidepressants can lead to voiding dysfunction by reducing detrusor contractility due to muscarinic receptor inhibition (17). Studies have also shown that trazodone increases internal urethral sphincter contraction through 5-HT 2a and α 1 receptors (18). It has been suggested that selective serotonin reuptake inhibitors (SSRIs) cause incontinence due to their agonistic effects on 5-HT 4 receptors.…”

Section: Introductionmentioning

confidence: 99%

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Investigation of the effect of trazodone on spontaneous and acetylcholine-induced bladder detrusor smooth muscle contractions

Gıca¹

2022

Dusunen Adam

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Objective: The management of psychiatric patients is often complicated by medical comorbidities, complex pharmacological regimens, and side effects secondary to these regimens. In the current study, it was aimed to investigate the effects and mechanism of action of trazodone on rat bladder smooth muscle contractility in vitro.Method: Sixteen adult male Wistar albino rats were euthanized by the cervical dislocation method following ether anesthesia. Two muscle strips of 2×10 mm in size were prepared vertically from the bladder by opening a longitudinal incision from the neck of the bladder in the direction of the apex. The strips were tied properly and hung in the organ bath. All contraction amplitudes and frequencies were recorded. After a 45-min adaptation period, contractions were induced by applying 10 -5 M acetylcholine (ACh) to all spontaneously contracting bladder strips. After 20 min, doses of trazodone (10 -9 M vs 10 -3 M) were given cumulatively. The resulting effects were recorded. Results:The groups were compared within themselves: a significant difference was found between the initial tensions in the group with ACh-induced contractions and the tensions after the administration of trazodone at 10 -9 , 10 -8 , 10 -7 , 10 -6 , 10 -5 , 10 -4 , and 10 -3 M doses (p<0.0001). In the group with spontaneous contractions, a significant difference was found between the initial tensions and the tensions after the administration of trazodone at 10 -9 , 10 -8 , 10 -5 , and 10 -4 M doses (p<0.0001). Conclusion:Results showed that trazodone had a significant inhibitory effect on bladder smooth muscle contractions in vitro, especially at concentrations of 10 -4 and 10 -3 M.

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Investigation of the effect of trazodone on spontaneous and acetylcholine-induced bladder detrusor smooth muscle contractions

Gıca¹

2022

Dusunen Adam

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A Pharmacovigilance Study on Psychotropic Agent-Induced Urinary Retention Using the Japanese Adverse Drug Event Report Database

Uekusa,

Mogi,

Ota

et al. 2024

Drugs - Real World Outcomes

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Introduction Psychotropic drugs have been reported to cause urinary retention (UR) via anticholinergic and other mechanisms. However, UR has not received much attention because of its non-fatal symptoms. We investigated the occurrence of UR associated with psychotropic drugs using the Japanese Adverse Drug Event Report (JADER) database. Methods Using the JADER database, we calculated reporting odds ratios for UR for 74 psychotropic drugs. Multivariate logistic regression analysis was used to adjust for the effects of sex, underlying disease, and age on UR. Variable selection included forced entry for sex, age, benign prostatic hyperplasia (BPH), depression, and backward-forward stepwise selection for each drug. Results A total of 887,704 cases were reported, of which 4653 (0.52%) had UR. In terms of sex, 0.79% (3401/429,372 cases) and 0.43% (1797/415,358 cases) of male and female patients had UR. In terms of age, 0.31% (892/288,676 cases) and 0.68% (3463/506,907 cases) of patients aged < 60 years and 60 years or older had UR. Among the underlying diseases, 8.22% (930/11,316 cases) and 0.43% (3723/876,388 cases) of patients with BPH and without BPH had UR, respectively. Further, 1.99% (337/16,959 cases) and 0.50% (4316/870,745 cases) of patients with depression and without depression had UR, respectively. Overall, 38 psychotropic drugs met the criteria for signal detection. In logistic regression, a total of 783,083 patients of discernible age and sex were included. The selected variables were sex, age, BPH, depression, and 23 drugs, including quetiapine [adjusted reporting odds ratio (ROR) 95% confidence interval (CI): 1.46–2.81], chlorpromazine (adjusted ROR 95%CI: 1.29–3.13), etizolam (adjusted ROR 95%CI: 1.47–3.09), maprotiline (adjusted ROR 95%CI: 1.99–8.34), mirtazapine (adjusted ROR 95%CI: 1.37–2.88), and duloxetine (adjusted ROR 95%CI: 2.15–4.21). Conclusions Many psychotropic drugs induce UR, which may be owing to their pharmacological effects. Appropriate monitoring is needed, especially in patients with other risk factors for UR.

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An Additive Mix? Acute Urinary Retention in a Patient With Benign Prostatic Hyperplasia Treated With Suboxone, Lurasidone, and Trazodone

Cited by 2 publications

References 34 publications

Investigation of the effect of trazodone on spontaneous and acetylcholine-induced bladder detrusor smooth muscle contractions

Investigation of the effect of trazodone on spontaneous and acetylcholine-induced bladder detrusor smooth muscle contractions

A Pharmacovigilance Study on Psychotropic Agent-Induced Urinary Retention Using the Japanese Adverse Drug Event Report Database

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