From the Guidelines
Sertraline is not commonly associated with urinary retention as a side effect, and there is limited evidence to suggest a significant link between the two. This SSRI antidepressant works by increasing serotonin levels in the brain, but it can also affect other neurotransmitters that influence bladder function. However, the provided evidence does not specifically mention urinary retention as a common adverse effect of sertraline 1.
Potential Mechanism
Urinary retention occurs when a medication's anticholinergic properties interfere with normal bladder contraction and relaxation of the urethral sphincter. While sertraline does have some anticholinergic effects, they are not as pronounced as those of other medications, which may explain why urinary retention is not a commonly reported side effect.
Patient Monitoring
Patients taking sertraline who experience difficulty urinating, incomplete bladder emptying, or a weak urine stream should contact their healthcare provider. This side effect is more likely in older adults, those with pre-existing urinary problems, or patients taking other medications with anticholinergic effects. If urinary retention develops, dose adjustment or medication change may be necessary. Staying well-hydrated and avoiding alcohol while taking sertraline may help minimize urinary side effects.
Clinical Considerations
Most patients tolerate sertraline without significant urinary problems, but monitoring for this potential side effect remains important, especially during the initial weeks of treatment. The available evidence suggests that sertraline is generally well-tolerated, with common adverse effects including nausea, diarrhea, dizziness, headache, insomnia, and sexual side effects 1. However, the risk of urinary retention should not be entirely ruled out, and patients should be advised to report any urinary symptoms to their healthcare provider.
From the Research
Sertraline and Urinary Retention
- Sertraline, a selective serotonin reuptake inhibitor (SSRI), has been reported to cause urinary retention in some cases 2, 3.
- A study published in 2007 reported two cases of women who experienced urinary hesitancy and retention after starting treatment with sertraline for depression, with symptoms resolving after discontinuation of the drug 2.
- Another case report published in 2023 found that intravenous dimenhydrinate can trigger the development of acute urinary retention in patients under long-term treatment with sertraline 3.
- A systematic review published in 2016 found that urinary retention occurred in 0.025% of patients on selective serotonin reuptake inhibitors, including sertraline 4.
- However, a study published in 1993 stated that serotonin reuptake inhibitors, including sertraline, do not cause urinary retention 5.
Comparison with Other SSRIs
- Another SSRI, escitalopram, has also been reported to cause acute urinary retention in a case report published in 2013 6.
- The systematic review published in 2016 found that duloxetine, a combined serotonin and noradrenaline reuptake inhibitor, did not report any cases of urinary retention in 1,139 patients 4.