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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by Cseagraves on March 19, 2009, at 12:35:31
What causes urine retention while on maoi's and what can you do to help it? Wouldn't urine retention cause you to get bladder infections easier?
Thanks,
Courtney
Posted by Phillipa on March 19, 2009, at 12:46:42
In reply to Urine retention on maoi?, posted by Cseagraves on March 19, 2009, at 12:35:31
Courtney don't the why's of the retention but would think it could cause more bladder infections as the urine stays in bladder longer. Are you drinking lots of water also add cranberry juice the real l00% kind. I'd call my doc also. Love Phillipa
Posted by bleauberry on March 19, 2009, at 16:40:12
In reply to Urine retention on maoi?, posted by Cseagraves on March 19, 2009, at 12:35:31
Easier to get bladder infections from urinary retention? Yes.
What causes it? Norepinephrine/adrenaline overstimulation of the alpha-1 receptors in the bladder, urinary tract, and prostate. MAOI will increase those hormones.
In Stahl's psychopharmacology book he suggests Tamsulosin (Flomax) to prevent that side effect. Flomax is an alpha-1 blocker with affinity mostly for the alpha-1 receptors in the urinary system more than the rest of the body or nervous system.
I had urinary retention real bad on Milnacipran. I had already decided for other reasons to stop Milnacipran, at least for the time being, but before I did I tried the lowest dose of Flomax. Indeed the urinary retention was completely cured within 24 hours.
I saw a pubmed study where the lowest dose was given to Reboxetine patients (NE reuptake inhibitor) for the urinary retention side effects, and it was 90% successful.
There are other alpha blockers as well.
Basically urinary retention is too much norepinephrine/adrenaline squeezing the muscles down there. Alpha blockers relax those muscles.
> What causes urine retention while on maoi's and what can you do to help it? Wouldn't urine retention cause you to get bladder infections easier?
>
> Thanks,
>
> Courtney
Posted by desolationrower on March 20, 2009, at 22:54:02
In reply to Re: Urine retention on maoi?, posted by bleauberry on March 19, 2009, at 16:40:12
hm. thinking, i might rather take nortriptyline. the alpha1 blockade can have a synergystic effect if it occurs in context of otherwise raised NA. overactivation outisde bladder might nto be as easily noticed but still beneficial.
-d/r
Posted by myco on March 21, 2009, at 23:09:50
In reply to Urine retention on maoi?, posted by Cseagraves on March 19, 2009, at 12:35:31
This is one of last side effects to leave you as you change up in dose and come towards the end of that side cycle.
> What causes urine retention while on maoi's and what can you do to help it? Wouldn't urine retention cause you to get bladder infections easier?
>
> Thanks,
>
> Courtney
Posted by sdb on March 22, 2009, at 16:52:06
In reply to Urine retention on maoi?, posted by Cseagraves on March 19, 2009, at 12:35:31
> What causes urine retention while on maoi's and what can you do to help it? Wouldn't urine retention cause you to get bladder infections easier?
>
> Thanks,
>
> Courtneyhi Cseagraves,
Medication can make voiding more difficult. Mostly these are anticholinergic effects from drugs. maos do have these effects also. The bladder and its sphincters are innervated by adrenergic stimuli, somatic innervation and the parasymphaticus. Most likely an anticholinergic like tricyclics, maos and other drugs will then affect the nerves with cholinergic signaling.
Clearly retention can cause a bladder infection but it must be stated what 'retention' means in your specific case. If you can void in a 'normal' rythm with 'normal' fillings there should be no problem even it is more difficult to void. If you have a chronic retention you should speak with your doctor and find out what the problem is, the drug or something else. Also for people who can't void exist necessary solutions to prevent a renal damage.
If you're a woman bladder infections are more common.
This is the end of the thread.
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