clozapine and Enuresis

Topics: Antipsychotic Agents; Clozapine; Enuresis; Humans; Urinary Incontinence

Topics: Affective Disorders, Psychotic; Aged; Antipsychotic Agents; Bipolar Disorder; Clozapine; Enuresis; Female; Humans; Psychotic Disorders

This report describes the efficacy of combined use of aripiprazole in the treatment of a patient with clozapine induced enuresis. Aripiprazole acts as a potential dopamine partial agonist and the dopamine blockade in the basal ganglia might be one of the causes of urinary incontinence and enuresis. We speculate that aripiprazole functioned as a D2 agonist in hypodopaminergic state of basal ganglia caused by clozapine and maintained dopamine level that would improve enuresis ultimately.

Topics: Adult; Antipsychotic Agents; Aripiprazole; Clozapine; Dopamine; Dopamine Agonists; Drug Therapy, Combination; Enuresis; Humans; Male; Middle Aged; Piperazines; Quinolones; Schizophrenia, Paranoid

We describe a patient with Schizophrenia and secondary enuresis. The enuresis settled with resolution of his psychotic symptoms but later remerged after starting Clozapine. We explore the mechanisms of incontinence in Schizophrenia and those due to Clozapine. This case highlights the need to inquire about incontinence in patients with schizophrenia prior to prescribing clozapine.

Topics: Antipsychotic Agents; Body Dysmorphic Disorders; Catalepsy; Clozapine; Comorbidity; Enuresis; Humans; Male; Schizophrenia, Catatonic; Young Adult

Topics: Antidiuretic Agents; Antipsychotic Agents; Clozapine; Deamino Arginine Vasopressin; Enuresis; Glasgow Coma Scale; Humans; Hyponatremia; Male; Middle Aged; Schizophrenia; Severity of Illness Index; Sodium

Topics: Adult; Clozapine; Deamino Arginine Vasopressin; Enuresis; Female; Humans; Male; Mandelic Acids; Parasympatholytics; Prevalence; Psychotic Disorders; Urination Disorders

Enuresis is an adverse event of clozapine treatment. The occurrence of nocturnal functional enuresis in two schizophrenic patients during the initial phase of clozapine therapy is reported. Beneficial effect of trihexyphenidyl administration (5 mg at 21.00 h) on clozapine-induced enuresis is clearly demonstrated in one patient. Trihexyphenidyl discontinuation and subsequent readministration in this patient led to corresponding recurrence and then disappearance of enuresis. Involvement of the cholinergic system has been proposed as one of the possible pathophysiological mechanisms of clozapine-induced enuresis.

Topics: Adult; Antipsychotic Agents; Clozapine; Enuresis; Humans; Male; Muscarinic Antagonists; Sialorrhea; Trihexyphenidyl

Topics: Adult; Clozapine; Deamino Arginine Vasopressin; Enuresis; Humans; Male; Psychotic Disorders

Urinary incontinence may occur in patients with severe mental illness. Psychosis and neuroleptic medication have both been implicated, but there has been a lack of systematic evaluation of the precise relationship between these phenomena. Incontinence has been recognized as a complication of clozapine treatment and we examined this in 16 consecutively treated patients. Thirteen were established on therapeutic doses, one of whom was excluded from further study due to pre-existing incontinence. Retrospective assessment revealed that nocturnal incontinence was experienced by five of the remaining 12 patients, occurring in the first 3 months of treatment and resolving spontaneously in all cases. Incontinence was documented in the case notes in only one of the five cases and there was a tendency for affected patients to be embarrassed and reluctant to report it to staff. Specific enquiry may be necessary to elicit this phenomenon and incontinence should be considered as a possible factor in poor compliance with clozapine.

Topics: Adult; Clozapine; Dose-Response Relationship, Drug; Enuresis; Female; Humans; Male; Middle Aged; Patient Compliance; Psychotic Disorders; Retrospective Studies; Urinary Incontinence

Topics: Adult; Clozapine; Deamino Arginine Vasopressin; Enuresis; Humans; Male; Schizophrenia