Reactions 1479, p15 - 23 Nov 2013

SEscitalopram

Acute urinary retention: case reportA 59-year-old man developed acute urinary retention while

receiving escitalopram.The man presented to a rehabilitation facility, post-

ischaemic, middle-cerebral artery infarct, which turnedhaemorrhagic. He had a history of asthma, new-onset atrialfibrillation, hypertension and obesity. He started salbutamol[albuterol]/ipratropium bromide as needed for shortness ofbreath or congestion upon admission. Nine days afteradmission, he started escitalopram 5mg daily [route notstated] for depression. He started to have trouble voiding, withdiscomfort 4 days after starting escitalopram.

The man required catheterisation, and postresidual voidwere monitored three to four times daily, with an averagepostvoid residual (PVR) volume of 239mL. He either did notvoid or needed to be catheterised for approximately 9 days.Ipratropium was suspected to be the offending agent;however, urinary retention persisted despite discontinuationof the medication. Escitalopram was then withdrawn, andwithin 2 days, he began to void on his own again, with PVRsaveraging 25mL. He remained continent for the remainder ofhis admission, and escitalopram was not later restarted.

Author comment: "Using the Naranjo Nomogram toassess the adverse drug reaction (ADR), a score of 7 wascalculated, indicating it is probable escitalopram was relatedto the patient’s acute urinary retention (AUR)."Trombetta D, et al. Escitalopram-associated acute urinary retention. ConsultantPharmacist 28: 661-669, No. 10, Oct 2013. Available from: URL: http://dx.doi.org/10.4140/TCP.n.2013.661 - USA 803096047

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Reactions 23 Nov 2013 No. 14790114-9954/13/1479-0001/$14.95 Adis © 2013 Springer International Publishing AG. All rights reserved