SYMPOSIA

Bulletin of Clinical Psychopharmacology, Vol: 21, Supplement: 2, 2011 - www.psikofarmakoloji.org
Poster Presentations
[PP-094] Ref. No: 291
Switching to fluoxetine due to sertraline-induced urinary incontinence: A case report
Pınar Güzel Özdemir 1 , Adem Aydın 1 , Mustafa Güleç 2 , Emine Füsün Akyüz Çim 1
1 Yuzuncu Yil University, Medical Faculty, Department of Pyschiatry, Van, Turkey
2 Ataturk University, Medical Faculty, Department of Pyschiatry, Erzurum, Turkey
E-mail: pguzelozdemir@yahoo.com
Urinary incontinence is involuntary leakage of urine. It is not life-threatening but adversely affects the quality of life (1). The patient usually
complains about frequent or periodic urinary incontinence in small amount or just leakage.
Here we report a case of urinary incontinence induced with sertraline and resolved after sertraline was discontinued.
Case: A 38 year-old married female patient presented to our clinic with complaints such as boredom, avolution, and depression. In
her history, there was no psychiatric treatment or treatment with any other medications. On her psychological examination, she was
cooperative, oriented, replying to questions briefly and properly. Her affect was depressive. The patient was diagnosed with depressive
disorder and prescribed sertraline 50mg/day. She was suggested to come to the clinic for follow up after 3 weeks, however she came back
a week later complaining of urinary incontinence. Without any pressure feeling, she developed urinary incontinence which negatively
affected her daily activities. Her medication was changed to fluoxetine 20mg/day from sertraline 50mg/day. Her urinary incontinence
complaint disappeared 2 days after. On the follow-up the patient did not have any urinary incontinence.
We presented a case report of urinary incontinence, which developed after starting sertraline. In the literature, there are case reports
about sertraline induced urinary incontinence and switching to fluoxetine (1,2).
Despite extensive research, the mechanism of enuresis has not been clarified in detail. Continence is maintained by alpha-adrenergically
mediated constriction of the bladder sphincter (3). Sertraline has alpha-adrenergic blockage, which may partially explain urinary incontinence
in our case.
Enuresis is usually underdiagnosed because of clinicians do not ascertain about it or the masking of this side effect by multiple drugs such
as antimuscarinic or noradrenergic agents (3).
Fluoxetine may be a choice in sertraline induced urinary incontinence cases in the treatment of depression and anxiety disorders. Larger
case series are needed on this issue.
Key words: Urinary incontinence, sertraline, fluoxetine
References:
1. Votolato NA, Stern S, Caputo RM: Serotonergic antidepressants and urinary incontinence Int Urogynecol J Pelvic Floor Dysfunct 2000;11:p 386–8.
2. Maalouf Fadi T, Gilbert Andrew R. Sertraline-Induced Enuresis in a Prepubertal Child Resolves after Switching to Fluoxetine. J Child Adolesc Psychopharmacol
2010;20:161
3. Andersson KE: Advances in the pharmacological control of the bladder. Exp Physiol 1999;84:195–213
Bulletin of Clinical Psychopharmacology 2011;21(Suppl. 2):S179
[PP-095] Ref. No: 292
The relationship between the serum bilirubin levels and metabolic syndrome
in schizophrenia patients
Filiz Karadağ 1 , Hasan Herken 1 , Bünyamin Kaptanoğlu 2 , Yaşar Enli 2 , Özgür Kalkancı 1 , Ceyhan Balcı Şengül 3 , Hüseyin Alaçam 1
1 Pamukkale University Medical Faculty Psychiatry Department, Denizli, Turkey
2 Pamukkale University Medical Faculty Biochemisry Department, Denizli, Turkey
*Denizli State Hospital, Denizli, Turkey
E-mail: filizlal@yahoo.com
Objective: Especially with the use of atypical antipsychotics, the increase of the metabolic side effects constitutes a major problem
in schizophrenia patients. Serum bilirubin levels have been reported to be associated with insulin resistance, abdominal obesity, and
metabolic syndrome (MS) (1,2). However, the relationship between MS parameters and bilirubin levels has not been investigated in
schizophrenia patients. It has been reported that antipsychotic drugs do not cause significant changes in serum bilirubin levels (3).
The objective of this study was to investigate the association between bilirubin levels and the parameters associated with MS in
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