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Eliezer DD, Lam C, Smith A, Coomarasamy JM, Samnakay N, Starkey MR, Deshpande AV. Optimising the management of children with concomitant bladder dysfunction and behavioural disorders. Eur Child Adolesc Psychiatry 2023; 32:1989-1999. [PMID: 35767104 PMCID: PMC10533605 DOI: 10.1007/s00787-022-02016-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Accepted: 05/26/2022] [Indexed: 11/03/2022]
Abstract
Bladder dysfunction and behavioural disorders in children are commonly concomitant; hence, it is difficult to treat each in isolation. Pharmacotherapy is common treatment for behavioural disorders, and these medications may have intended or unintended positive or negative bladder sequelae. This review identifies the literature regarding the effects of behavioural pharmacotherapy on bladder functioning and possible bladder management strategies in children with concomitant behaviour and bladder disorders to enable clinicians to better manage both conditions. A PROSPERO registered PRISMA-guided review of three major databases was performed. After an initial scoping study revealed significant heterogeneity, a narrative approach was undertaken to discuss the results of all relevant cases relating to children being treated with pharmacotherapy for behaviour disorders and outcomes related to bladder function. Studies were screened to identify those that described effects of commonly prescribed medications in children with behavioural disorders such as stimulants, alpha 2 agonists, tricyclic antidepressants (TCA), serotonin and noradrenergic reuptake inhibitors (SNRI), selective serotonin reuptake inhibitors (SSRI) and antipsychotics, and the findings and implications were summarised. The review identified 46 studies relevant to behavioural pharmacotherapy and bladder function (stimulants (n = 9), alpha 2 agonists (n = 2), TCAs (n = 7), SNRIs (n = 8), SSRIs (n = 8) and antipsychotics (n = 6). Six studies focused specifically on bladder management in children with behavioural disorders with concurrent behavioural pharmacotherapy. This review identifies useful factors that may assist clinicians with predicting unintended bladder effects following initiation of behavioural pharmacotherapy to facilitate the best approach to the treatment of bladder dysfunction in children with behavioural disorders. With this evidence, we have provided a useful decision-making algorithm to aide clinicians in the management of these dual pathologies.
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Affiliation(s)
- Dilharan D Eliezer
- John Hunter Children's Hospital, New Lambton Heights, NSW, Australia.
- University of Newcastle, Newcastle, NSW, Australia.
- Urology Unit, Department of Surgery, Department of Paediatric Surgery, The Children's Hospital at Westmead, Locked Bag 4001, Westmead, NSW, 2145, Australia.
| | - Christopher Lam
- John Hunter Children's Hospital, New Lambton Heights, NSW, Australia
- University of Newcastle, Newcastle, NSW, Australia
| | - Angela Smith
- Hunter New England Library, New Lambton Heights, NSW, Australia
| | | | - Naeem Samnakay
- Department of Surgery, Perth Children's Hospital, Nedlands, WA, Australia
- Division of Surgery, Medical School, University of Western Australia, Crawley, WA, Australia
| | - Malcolm R Starkey
- Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
- Department of Immunology and Pathology, Central Clinical School, Monash University, Melbourne, Australia
| | - Aniruddh V Deshpande
- John Hunter Children's Hospital, New Lambton Heights, NSW, Australia
- University of Newcastle, Newcastle, NSW, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
- Urology Unit, Department of Surgery, Department of Paediatric Surgery, The Children's Hospital at Westmead, Locked Bag 4001, Westmead, NSW, 2145, Australia
- Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, NSW, Australia
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Boyer MG, Kheloufi F, Denis J, Micallef J, Milh M. Urinary retention associated with aripiprazole: Report of a new case and review of the literature. Therapie 2018; 73:287-289. [DOI: 10.1016/j.therap.2017.09.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Revised: 06/28/2017] [Accepted: 09/21/2017] [Indexed: 10/18/2022]
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Faure Walker N, Brinchmann K, Batura D. Linking the evidence between urinary retention and antipsychotic or antidepressant drugs: A systematic review. Neurourol Urodyn 2015; 35:866-874. [PMID: 26288221 DOI: 10.1002/nau.22851] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2015] [Accepted: 07/21/2015] [Indexed: 01/22/2023]
Abstract
AIMS Urinary retention (UR) occurs in patients on antipsychotic and antidepressant medication despite no apparent underlying urological cause. This review was undertaken to ascertain which of these medications are associated with UR and how often. METHODS A systematic literature search for evidence on antipsychotic and antidepressant medications and UR was completed in June 2015 using Scopus, Pubmed, Web of Science, and the Cochrane library. Search terms included urinary retention, antidepressants and antipsychotics as well as individual drug names. Filters used were: humans and English language. PRISMA guidelines were employed. RESULTS Out of 614 articles initially identified, one meta-analysis, five RCT's, five cohort studies and 27 case reports were finally included. There was a wide range of definitions of UR. Studies which appropriately defined UR revealed it occurred in 1/21 patients on ziprasidone (an atypical antipsychotic), 17.6% of those on imipramine but only 0.1% of those on all tricyclic antidepressants analysed together. It was not reported in any of the 1,139 patients given duloxetine (a combined serotonin and noradrenaline reuptake inhibitor). It was reported in 0.025% of patients on selective serotonin reuptake inhibitors. UR was also reported in patients on typical antispychotics, selective noradrenaline reuptake inhibitors but the studies did not define UR. The majority of case reports reported an improvement in UR on discontinuation or dose reduction. CONCLUSION Antipsychotics and antidepressants interact with the urinary system in many ways. Clinicians treating acute UR need to keep in mind the role of antipsychotic and antidepressants as a precipitating cause. Neurourol. Urodynam. 35:866-874, 2016. © 2015 Wiley Periodicals, Inc.
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Affiliation(s)
- Nicholas Faure Walker
- Department of Urology, St Georges Healthcare NHS Foundation Trust, London, United Kingdom
| | - Katherine Brinchmann
- Department of Urology, London North West Healthcare NHS Trust, London, United Kingdom
| | - Deepak Batura
- Department of Urology, London North West Healthcare NHS Trust, London, United Kingdom.
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