Treatment-emergent incontinence with lithium.

Four (17%) of 23 consecutive female outpatients developed significant urinary or urgency incontinence when treated with lithium carbonate. The symptoms remitted or abated with the addition of oxybutynin (an anticholinergic drug), imipramine, or with decreased lithium dosing. A proposed mechanism involves lithium-induced changes in bladder cholinergic-adrenergic balance.