Failure of tolterodine to treat clozapine-induced nocturnal enuresis.

Abstract

OBJECTIVE:

To report the use and subsequent failure of the bladder-selective agent tolterodine, to treat clozapine-induced nocturnal enuresis in an adolescent patient with psychotic illness.

CASE SUMMARY:

A 16-year-old Hispanic girl was admitted to the state psychiatric hospital with a diagnosis of bipolar disorder with psychotic features. Clozapine therapy was initiated, and after three months of treatment the patient began experiencing episodes of nocturnal enuresis. The bladder-selective agent tolterodine was tried and subsequently failed to resolve the enuresis episodes. Desmopressin was initiated, which resulted in amelioration of symptoms.

DISCUSSION:

This is the first published report of using tolterodine to treat clozapine-induced nocturnal enuresis. Several methods to decrease clozapine-induced urinary incontinence have been used and typically include the addition of agents with high anticholinergic properties. Tolterodine is a bladder-selective anticholinergic agent indicated for the treatment of urinary urge incontinence and may be employed as a treatment for antipsychotic-induced incontinence.

CONCLUSIONS:

Nocturnal enuresis is an adverse effect that infrequently occurs with use of clozapine therapy. Although tolterodine was ineffective in our patient to treat clozapine-induced nocturnal enuresis, further trials are required to appropriately evaluate the effectiveness of tolterodine to treat this adverse drug reaction.

• Authors: B A English, D J Still, J Harper, S R Saklad
• Journal: The Annals of pharmacotherapy (Ann Pharmacother) 2001 Jul-Aug Vol. 35 Issue 7-8 Pg. 867-9 ISSN: 1060-0280 [Print] United States
• PMID: 11485135 (Publication Type: Case Reports, Journal Article)

Chemical References

• Antipsychotic Agents
• Benzhydryl Compounds
• Cresols
• Muscarinic Antagonists
• Phenylpropanolamine
• Tolterodine Tartrate
• Clozapine

Topics

• Adolescent
• Antipsychotic Agents (adverse effects)
• Benzhydryl Compounds (therapeutic use)
• Clozapine (adverse effects)
• Cresols (therapeutic use)
• Enuresis (chemically induced, drug therapy)
• Female
• Humans
• Muscarinic Antagonists (therapeutic use)
• Phenylpropanolamine
• Psychotic Disorders (drug therapy)
• Tolterodine Tartrate
• Treatment Failure