From the FDA Drug Label
Renal and urinary disorders: urinary incontinence, urinary retention
- Trazodone may cause urinary retention as it has been reported in post-marketing experience 1.
- This adverse reaction is listed under Renal and urinary disorders in the post-marketing experience section of the drug label.
- Urinary retention has been identified during post-approval use of Trazodone Hydrochloride Tablets.
From the Research
Trazodone can potentially cause urinary retention as a side effect, though it is not among its most common adverse effects, as reported in a study published in 2018 2. This anticholinergic side effect occurs because trazodone can block certain receptors that affect bladder function, particularly in elderly patients or those with pre-existing urinary issues. Some key points to consider:
- Patients taking trazodone who experience difficulty urinating, incomplete bladder emptying, or a decreased urinary stream should contact their healthcare provider promptly.
- The risk of urinary retention is dose-dependent, with higher doses (above 150-200 mg daily) more likely to cause problems, as suggested by a study published in 2016 3.
- This side effect is more common in older adults, men with enlarged prostates, and patients taking other medications with anticholinergic properties.
- If urinary retention develops, dose reduction or medication change may be necessary, as recommended in a study published in 2018 4.
- Staying well-hydrated and avoiding alcohol while taking trazodone can help minimize urinary complications.
- Patients with a history of urinary retention or prostate problems should inform their doctor before starting trazodone therapy, as advised in a study published in 2008 5.
In terms of management, a study published in 2018 4 recommends assessment of urethral patency with prompt and complete bladder decompression by catheterization, and further management can include initiation of alpha blockers with voiding trials. It's also important to note that trazodone's minimal anticholinergic activity, as reported in a study published in 2012 6, may contribute to the risk of urinary retention, although the exact mechanism is not fully understood. Overall, while trazodone can cause urinary retention, the risk can be minimized with proper management and patient education.