No go... urinary hesitancy with reboxetine

(from West Midlands Centre for
Adverse Drug Reactions Reporting)

Br. J. Psychiatry 1998: 173: 441-2)

"We have recently received two reports of urinary hesitancy associated with the use of reboxetine to treat depression. The first involved a 53 year-old man who developed symptoms 2 days after starting the drug and recovered 4 days after stopping treatment. The second concerned a 67 year-old man whose symptoms started immediately on taking the drug and stopped immediately on stopping treatment.

The first case report of urinary hesitancy with reboxetine has just been published. It details a 59 year-old man who started reboxetine 4 mg twice daily for depression and had symptoms of urinary hesitancy and inability to void his bladder completely. This patient stopped reboxetine after ten months' treatment, but restarted it when his depression recurred two weeks later, in conjunction with doxazosin 1 mg per day. His urinary symptoms did not recur. In this case it was a urologist who suggested that the urological symptoms may be related to reboxetine use. It is likely that the urinary hesitancy is caused by the potentiation of sympathetically released noradrenaline in the urinary bladder. The alpha-blockade by doxazosin seemed to have prevented a recurrence of symptoms on restarting the treatment."

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