From the Guidelines
Urinary retention is a potential side effect of Atomoxetine (Strattera), as it can affect norepinephrine levels in the body, which play a role in bladder control and urination. This is based on the evidence from a 2022 study published in Pharmacology and Therapeutics 1, which highlights the pharmacological properties of atomoxetine, including its impact on norepinephrine and dopamine levels in the brain. Although the study does not explicitly mention urinary retention as a side effect, it does mention "effects on urine outflow" as a warning associated with atomoxetine treatment 1.
To manage this potential side effect:
- Don't stop taking atomoxetine suddenly without consulting your doctor.
- Stay well-hydrated to help maintain urinary function.
- Practice timed voiding (urinating on a schedule) to help empty your bladder regularly.
- If symptoms persist or worsen, your doctor may consider lowering the dose or switching to a different medication. Some common adverse effects of atomoxetine include nausea, vomiting, fatigue, decreased appetite, abdominal pain, and somnolence 1. However, it is essential to monitor for signs of urinary tract infections, as incomplete bladder emptying can increase the risk. Seek immediate medical attention if you experience severe pain, fever, or inability to urinate at all.
Key considerations for patients taking atomoxetine include close monitoring for suicidality, clinical worsening, and unusual changes of behavior, especially during the first few months of treatment or at times of dose change 1. Additionally, warnings exist for preexisting cardiovascular diseases, significant cardiac abnormalities, emergent psychotic or manic symptoms, bipolar disorder, aggressive behavior or hostility, possible allergic reactions, and priapism in children, adolescents, and adults 1.
From the FDA Drug Label
5.9 Effects on Urine Outflow from the Bladder In adult ADHD controlled trials, the rates of urinary retention 1.7% (9/540) and urinary hesitation 5. 6% (30/540) were increased among atomoxetine subjects compared with placebo subjects (0%, 0/402 ; 0.5%, 2/402, respectively). Two adult atomoxetine subjects and no placebo subjects discontinued from controlled clinical trials because of urinary retention. A complaint of urinary retention or urinary hesitancy should be considered potentially related to atomoxetine.
Yes, urinary retention is a side effect of Atomoxetine (Strattera) as it occurred in 1.7% of adult patients in controlled trials, which is a higher rate compared to placebo subjects 2.
From the Research
Urinary Retention as a Side Effect of Atomoxetine
- Atomoxetine is a selective norepinephrine reuptake inhibitor used to treat attention-deficit/hyperactivity disorder (ADHD) 3.
- According to the prescribing information, genitourinary-related adverse events such as urinary hesitancy/retention and priapism are listed as precautions for atomoxetine 4.
- A case report describes a 42-year-old male who experienced urinary hesitancy with milky, white-colored discharge after initiating atomoxetine 40 mg daily, which resolved within 2 days of discontinuation 4.
- The study suggests that urine outflow obstruction-related adverse events occur more commonly in men compared to women, and discontinuation of atomoxetine appears to lead to rapid resolution of the adverse events 4.
Comparison with Other Studies
- Other studies have investigated the efficacy and safety of atomoxetine in treating ADHD, but they do not specifically mention urinary retention as a side effect 3, 5, 6.
- A study on the effect of atomoxetine on behavioral difficulties and growth development in primary school children with ADHD found that the most common adverse reactions were gastrointestinal symptoms, but did not mention urinary retention 5.
- A comparison study between atomoxetine and extended-release viloxazine for ADHD found that 36% of patients discontinued atomoxetine due to side effects, including gastrointestinal upset, irritability, fatigue, and insomnia, but did not specifically mention urinary retention 6.