Clozapine enuresis with

The vast majority of children with enuresis have normal uro-dynamics, including nocturnal bladder capacity. Functional bladder capacity can be estimated using this formula age in years + 2 = ounces of capacity. In some children, there appears to be a relationship between developmental immaturity (motor and language milestones) and enuresis, but the mechanism is unknown. Drugs like lithium, clozapine, risperidone,... 

Enuresis has been rarely associated with clozapine (0.23% of patients) (SEDA-19, 54) (191), and has been successfully treated with benzatropine in patients taking a variety of psychotropic medications (192). 

Since the adverse effects of clozapine may be more common in children than adults, perhaps reflecting developmental pharmacokinetic differences, clozapine and its metabolites, norclozapine and clozapine-N-oxide, have been studied in six youths aged 9-16 years, with childhood onset schizophrenia (222). Dose-normalized concentrations of clozapine did not vary with age and were similar to reported adult values. Clinical improvement in five patients correlated with serum clozapine concentrations, and clinical response and total number of common adverse effects (sialorrhea, n = 5 tachycardia, n = 4 sedation, n = 1 enuresis, n = 1) correlated with norclozapine concentrations. One child had a reduced neutrophil count (1.1 x 109/1) and another child had increased hepatic transaminases. 

Urinary tract Urinary system adverse reactions, especially enuresis, have been associated with clozapine [SED-15, 832] with an estimated incidence greater than 6%. The mechanisms include overflow incontinence after urinary retention due to the anti-muscarinic action of clozapine or a cholinomimetic activity, and reduced internal urethral sphincter tone caused by aj adrenoceptor blockade enuresis has also been attributed to a non-specific action of clozapine such as excessive sedation, lowering of the seizure threshold, and constipation exacerbating urinary retention and over-fiow. Secondary enuresis in a 21-year man with schizophrenia settled with resolution of his psychotic symptoms but later remerged after starting clozapine [SS ]. 

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