Psychopharmacology Severe urinary retention associated with combined use of duloxetine and quetiapine in an elderly patient: a case report

Duloxetine, a potent reuptake inhibitor of serotonin and norepinephrine, is effective for the treatment of major depressive disorder, generalized anxiety disorder, diabetic neuropathic pain, stress urinary incontinence and fibromyalgia. Urinary retention, an adverse side effect which has to be carefully followed, is more commonly seen with tricyclic antidepressants and in elderly patients. Here we report an 86 years old patient, who were administered duloxetine and quetiapine due to the symptoms of depression and generalized anxiety disorder. He was admitted to our clinic and hospitalized with complaints of abdominal pain and with the idea of poisoning, which were initially thought to be psychotic symptoms. However, after clinical and laboratory evaluation, he was diagnosed as acute renal failure associated with postrenal obstruction. He was treated with urinary catheterization and cassation of medication. The adverse effects of duloxetine on the urinary system and the difficulty of the treatment of elderly patients suffering from psychiatric disorders are emphasized with this case.