2018
DOI: 10.2478/gp-2018-0007
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Nocturnal Enuresis is an Under-recognised Side Effect of Clozapine: Results of a Systematic Review

Abstract: ObjectivesClozapine is an effective antipsychotic medication licenced for the management of treatment resistant schizophrenia. Due to its non-selective pharmacology, it has a broad range of side effects. Nocturnal enuresis secondary to the use of clozapine has been documented in the literature but may be overlooked, the link between drug and symptom being clinically unnoticed. Patients may not mention urinary symptoms due to supervening psychosis, co-existing symptomatology, embarrassment or shame. By raising … Show more

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Cited by 5 publications
(10 citation statements)
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References 22 publications
(34 reference statements)
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“…These medications were generally well tolerated, although 63% of studies did not discuss adverse effects. Despite the high incidence of clozapine-induced nocturnal enuresis and urinary incontinence, 7 there is limited available literature on management and interventions. This may be in part due to the underreporting of urinary symptoms due of stigma leading to a lack of attention to the issue.…”
Section: Discussionmentioning
confidence: 99%
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“…These medications were generally well tolerated, although 63% of studies did not discuss adverse effects. Despite the high incidence of clozapine-induced nocturnal enuresis and urinary incontinence, 7 there is limited available literature on management and interventions. This may be in part due to the underreporting of urinary symptoms due of stigma leading to a lack of attention to the issue.…”
Section: Discussionmentioning
confidence: 99%
“…7 The prevalence of nocturnal enuresis and urinary incontinence is thought to be underreported and may affect up to 40% of those prescribed clozapine. 7 Some cases may spontaneously resolve, although many demonstrate chronicity and impact quality of life. Patients may experience stigma, embarrassment, loss of quality sleep, impaired sexual function, and dissatisfaction with hygiene, in addition to the cost of incontinence supplies and additional laundry.…”
Section: Introductionmentioning
confidence: 99%
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“…Other clinically relevant side effects: hepatitis, nephritis, pancreatitis 419,420 , delirium*, enuresis, NMS 90,91,146,298,421,422 , DRESS syndrome 392,423 , venous thromboembolism 148,162 , diabetic ketoacidosis, hyperosmolar coma 148,251  Clinical assessment, laboratory parameter 424  Cave: delirium associated with high clozapine doses and with abrupt clozapine discontinuation 274,424  NMS: rare (clozapine drug of first choice after NMS) 298,422,425  Pancreatitis: screen for signs of exocrine and endocrine pancreas insufficiency  DRESS syndrome: assess laboratory parameter frequently (especially eosinophils, lymphocytes) 392,423 ; risk factor: combination with lithium, anticonvulsants (incl. valproate)…”
Section: Fridericia) 137mentioning
confidence: 99%
“… Enuresis: avoid late fluid intake, continence training, desmopressin 91,421,426  Hepatitis, pancreatitis, nephritis: rare; discontinue clozapine, initiate specific treatment 91,420,427  Delirium: pause clozapine…”
Section: Fridericia) 137mentioning
confidence: 99%