Sinha Preeti, Gupta Anupam, Reddi V Senthil Kumar, Andrade Chittaranjan
Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India.
Department of Neurological Rehabilitation, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India.
Indian J Psychiatry. 2016 Oct-Dec;58(4):438-442. doi: 10.4103/0019-5545.196719.
This is an exploratory study, which aimed to analyze urodynamic findings in patients who are on atypical antipsychotics and present with urinary incontinence (UI) in order to understand the mechanisms of antipsychotic-emergent UI.
Eight patients (34 ± 7.6 years; five males and three females) diagnosed with schizophrenia or other psychotic disorders, who were on risperidone, olanzapine, or clozapine monotherapy and having UI were recruited. Urodynamic study was performed in all patients.
Six out of eight (75%) patients had abnormal urodynamic findings. Three of them had detrusor overactivity (DO) without detrusor-sphincter dyssynergia (DSD); two had DO with DSD; and one had hypoactive detrusor with nonrelaxing sphincter during void phase. The common urinary symptoms were urgency, enuresis, and straining to void urine. Significant postvoid residual urine was found in two patients.
The evidence of bladder dysfunction in atypical antipsychotic-emergent UI is similar to that present in patients with neurological disorders. Urinary complaints in patients on antipsychotics thus need to be evaluated and managed systematically using the protocol followed for neurological conditions.
这是一项探索性研究,旨在分析使用非典型抗精神病药物且出现尿失禁(UI)的患者的尿动力学检查结果,以了解抗精神病药物所致尿失禁的机制。
招募了8例(年龄34±7.6岁;5例男性,3例女性)被诊断为精神分裂症或其他精神障碍、正在接受利培酮、奥氮平或氯氮平单药治疗且患有尿失禁的患者。对所有患者进行了尿动力学检查。
8例患者中有6例(75%)尿动力学检查结果异常。其中3例有逼尿肌过度活动(DO)但无逼尿肌-括约肌协同失调(DSD);2例有DO合并DSD;1例在排尿期逼尿肌活动减退且括约肌不松弛。常见的泌尿系统症状为尿急、遗尿和排尿费力。2例患者发现有明显的残余尿。
非典型抗精神病药物所致尿失禁中膀胱功能障碍的证据与神经系统疾病患者相似。因此,对于使用抗精神病药物的患者的泌尿系统主诉,需要按照针对神经系统疾病的方案进行系统评估和处理。