Urine retention, antidepressants

I Contraindications Amgle-closure glaucoma, hypersensitivityto other tricyclic antidepressants, urine retention... 

Whereas antipsychotics and antidepressants are used mainly in major psychiatry , Le. in the treatment of schizophrenia and depression, anxiolytics are also used in general medicine for the treatment of neurotic, vegetative, psychosomatic and even purely physical conditions. This multiple usage is promoted by the fact that anxiolytics of the benzodiazepine type have an almost exclusively central action so that vegetative effects (dry mouth, sweating, visual disturbances, urine retention, constipation, fall in blood pressure), which can be unpleasant for patients or even hazardous, are practically absent. 

The interactions with cimetidine are well established, well documented and of clinical importance. The incidence is uncertain hut most patients could be affected. Those taking amitriptyline, desipramine, doxepin, imi-pramine or nortriptyline who are given cimetidine should be warned that adverse effects such as mouth dryness, urine retention, blurred vision, constipation, tachycardia, postural hypotension may be more likely to occur. Other tricyclic antidepressants would be expected to be similarly affected. If symptoms are troublesome reduce the dosage of the antidepressant (33 to 50% has been suggested) or replace the cimetidine with ranitidine, which does not appear to interact. Other H2-ieceptor antagonists that do not cause enzyme inhibition (e.g. famotidine and nizatidine) would also not be expected to interact. 

The retention times corresponding to the antidepressants imipramine, amitriptyline, trimipramine, and chlorimipramine are shown in Table 14.6. Five nanograms of each were added to 1 mL of either urine, plasma, or blood and extracted with Sep-Pak cartridge, as indicated above. Recoveries are above 60%. Linear detector response is obtained between 10 and 80 pg in the injected volume (10-80 ng/mL). The lower limit of detection provides an extremely sensitive alternative to the standard thermoionic ionization detector (17). 

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