From the FDA Drug Label
Common possible side effects in people who take sertraline include: ... urinary incontinence Other side effects in children and adolescents include: ... urinating more often urinary incontinence Other Adverse Events in Pediatric Patients ... were reported at an incidence of at least 2% and occurred at a rate of at least twice the placebo rate (N=281 patients treated with sertraline): ... urinary incontinence
Sertraline can cause urinary incontinence as a side effect.
- Urinary incontinence is listed as a possible side effect of sertraline in the drug label 1.
- The drug label also mentions that urinary incontinence was reported in pediatric patients treated with sertraline at an incidence of at least 2% and occurred at a rate of at least twice the placebo rate 1.
- Another drug label for sertraline also lists urinary incontinence as an adverse event reported during premarketing assessment of sertraline in clinical trials 1. There is no information about trazodone in the provided drug labels.
From the Research
Yes, sertraline and trazodone, which are sometimes prescribed for agitation in dementia patients, can potentially cause urinary incontinence as a side effect. Both medications affect serotonin levels in the brain, which can influence bladder function. Sertraline, a selective serotonin reuptake inhibitor (SSRI), may cause urinary retention in some patients, which can paradoxically lead to overflow incontinence, as reported in a study published in 2007 2. Trazodone, an antidepressant often used at lower doses (25-100mg) for sleep and agitation in dementia, can cause urinary retention or incontinence due to its effects on both serotonin receptors and its mild alpha-adrenergic blocking properties. These side effects are more common in older adults with dementia who often have age-related changes in bladder function and may already be at risk for incontinence. A study published in 2002 found that the use of SSRIs, including sertraline, was associated with an increased risk of urinary incontinence, with an estimated 14 extra cases per 1000 patients treated per year 3. If a patient develops new or worsening urinary symptoms after starting these medications, healthcare providers should evaluate whether the medications are contributing factors, as suggested in a review of treatment options for agitation in dementia published in 2019 4. Sometimes, adjusting the dose or switching to alternative medications for managing dementia-related agitation may be necessary to address these urinary side effects while still treating the behavioral symptoms. The efficacy and safety of antidepressants, including sertraline and trazodone, in treating agitation and psychosis in dementia have been reviewed in several studies, including a Cochrane review published in 2011 5 and a review of sertraline's clinical use published in 2009 6. However, the most recent and highest quality study on this topic is the 2019 review of treatment options for agitation in dementia 4, which highlights the importance of considering the potential side effects of these medications, including urinary incontinence, when managing agitation in dementia patients. Key points to consider when prescribing sertraline and trazodone for agitation in dementia include:
- Monitoring for urinary side effects, such as retention or incontinence
- Adjusting the dose or switching to alternative medications if necessary
- Considering the patient's age-related changes in bladder function and risk of incontinence
- Evaluating the potential benefits and risks of these medications in managing dementia-related agitation.