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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by tensor on April 6, 2010, at 5:49:59
Which medications exist that can help with urinary retention caused by TCA(aCh)? I know there's bethanechol, but are there others?
/Mattias
Posted by Viking on April 6, 2010, at 9:32:41
In reply to TCA-induced urinary retention, posted by tensor on April 6, 2010, at 5:49:59
Flomax (Tamsulosine) is often combined with Reboxetine to counteract the urinary retension caused by Reboxetine.
I guess it will work with a TCA as well, as TCAs are also NRIs.
Posted by tensor on April 6, 2010, at 10:02:21
In reply to Re: TCA-induced urinary retention, posted by Viking on April 6, 2010, at 9:32:41
Unfortunately not. With TCAs the urinary hesitancy is an anticholinergic side effect. While in NRIs it comes from stimulation of alpha1-adrenergic receptors, that's why tamsulosin, which is an alpha1 blocker, helps.
Most TCAs are strong alpha1 blockers.Thanks anyway,
Mattias> Flomax (Tamsulosine) is often combined with Reboxetine to counteract the urinary retension caused by Reboxetine.
>
> I guess it will work with a TCA as well, as TCAs are also NRIs.
Posted by Phillipa on April 6, 2010, at 10:47:51
In reply to Re: TCA-induced urinary retention » Viking, posted by tensor on April 6, 2010, at 10:02:21
Mattias didn't know that. Is that the antihistamine effects of the TCA's the drying effect? Phillipa
Posted by tensor on April 6, 2010, at 10:56:48
In reply to Re: TCA-induced urinary retention » tensor, posted by Phillipa on April 6, 2010, at 10:47:51
> Mattias didn't know that. Is that the antihistamine effects of the TCA's the drying effect? Phillipa
Nope, anticholinergic side effect.
Posted by bleauberry on April 6, 2010, at 17:16:10
In reply to TCA-induced urinary retention, posted by tensor on April 6, 2010, at 5:49:59
Flomax.
Posted by bleauberry on April 6, 2010, at 17:19:22
In reply to TCA-induced urinary retention, posted by tensor on April 6, 2010, at 5:49:59
It is folly to try to predict in advance whether urinary retention is anticholinergic or adrenergic, or some complicated combination of both. Therefore, ruling out any potential medication based on theory won't work. All the potential candidates have to be tried. Just because a med has strong anticholinergic activity doesn't mean that is causing the urinary retention.
Another person here about a year ago was helped completely by the addition of Flomax to his TCA.
Posted by tensor on April 6, 2010, at 23:42:25
In reply to Re: TCA-induced urinary retention, posted by bleauberry on April 6, 2010, at 17:19:22
> It is folly to try to predict in advance whether urinary retention is anticholinergic or adrenergic, or some complicated combination of both. Therefore, ruling out any potential medication based on theory won't work. All the potential candidates have to be tried. Just because a med has strong anticholinergic activity doesn't mean that is causing the urinary retention.
>
> Another person here about a year ago was helped completely by the addition of Flomax to his TCA.Ok, I was just thinking that the blood pressure could become very low, followed by more severe ortostatic hypotension and complete black-out. Since the TCAs I'm considering (clomipramine) already have this property. Any thoughts?
/Mattias
Posted by ed_uk2010 on April 7, 2010, at 13:51:56
In reply to Re: TCA-induced urinary retention » bleauberry, posted by tensor on April 6, 2010, at 23:42:25
> > It is folly to try to predict in advance whether urinary retention is anticholinergic or adrenergic, or some complicated combination of both. Therefore, ruling out any potential medication based on theory won't work. All the potential candidates have to be tried. Just because a med has strong anticholinergic activity doesn't mean that is causing the urinary retention.
> >
> > Another person here about a year ago was helped completely by the addition of Flomax to his TCA.
>
> Ok, I was just thinking that the blood pressure could become very low, followed by more severe ortostatic hypotension and complete black-out. Since the TCAs I'm considering (clomipramine) already have this property. Any thoughts?
>
> /MattiasDo you remember any urinary problems when you took clomipramine before?
Posted by tensor on April 7, 2010, at 15:11:59
In reply to Re: TCA-induced urinary retention, posted by ed_uk2010 on April 7, 2010, at 13:51:56
> Do you remember any urinary problems when you took clomipramine before?
>No I don't remember, maybe it wasn't too bad. Thought I might be good to have a backup plan, just in case. On nortrip it was definately bad.
/Mattias
Posted by ed_uk2010 on April 7, 2010, at 17:14:45
In reply to Re: TCA-induced urinary retention » ed_uk2010, posted by tensor on April 7, 2010, at 15:11:59
>No I don't remember......
That's a good sign :)
This is the end of the thread.
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