Does Fluoxetine affect urination? (3 factors)
By
Dr Milena Locci de Oliveira (PhD)
Author bio
Dr Milena Locci de Oliveira is a Pharmacist and Doctor of Philosophy in Sciences from the University of São Paulo (USP). She has experience in microbiology, analytical toxicology, and clinical pharmacokinetics. She writes and reviews content on these topics.
Dr Milena’s Highlights:
-PhD in Sciences, University of São Paulo, Brazil, 2019.
-University College London (UCL) – Semester of remote collaboration in the areas of Pharmacometrics and Population Pharmacokinetics, 2018.
-Bachelor in Biochemical Pharmacy, University of São Paulo, Brazil, 2013.
“Science can be translated, and it is essential that everyone has access to quality information to make informed decisions” – Dr Milena Oliveira, PhD.
Professional Experience:
With a decade-long career as a researcher, Dr Milena has amassed extensive experience in conducting research projects in microbiology, analytical toxicology, and clinical pharmacokinetics.
Her expertise also extends to the preparation of technical and scientific reports, literature reviews, data analysis, and scientific communication, both oral and written.
Dr Milena has served as a Clinical Pharmacist, providing expert supervision and guidance to teams during the challenging times of the COVID-19 pandemic, particularly in the ICUs of two reference hospitals for patient hospitalization.
In her most recent role, Dr Milena worked on the implementation of the deliberatives of the São Paulo State Government Pharmaceutical Assistance Coordination. These decisions were aimed at ensuring medication access within the Unified Health System.
A widely multidisciplinary background enabled Dr Milena to become a professional capable of integrating scientific knowledge into private initiatives, education, and healthcare, delivering consistent services in patient safety and population health.
Professional Memberships & Affiliations:
Dr Milena Oliveira is a member of the Regional Council of Pharmacy of the State of São Paulo, Brazil.
Education:
-PhD in Sciences, University of São Paulo, Brazil, 2019.
-University College London (UCL) – Semester of remote collaboration, 2018.
-Bachelor in Biochemical Pharmacy, University of São Paulo, Brazil, 2013.
Relevant Published Work & Citations:
Oliveira ML de, Rocha A, Nardotto GHB, Pippa LF, Simões BP, Lanchote VL. Analysis of daunorubicin and its metabolite daunorubicinol in plasma and urine with application in the evaluation of total, renal and metabolic formation clearances in patients with acute myeloid leukemia. Journal of Pharmaceutical and Biomedical Analysis. Nov 2020. 191:113-124.
Abstracts. CPT: Pharmacometrics & Systems Pharmacology. 2020 Nov; 9 (S1).
Pippa LF, Oliveira ML de, Rocha A, de Andrade JM, Lanchote VL. Total, renal and hepatic clearances of doxorubicin and formation clearance of doxorubicinol in patients with breast cancer: Estimation of doxorubicin hepatic extraction ratio. Journal of Pharmaceutical and Biomedical Analysis. 2020 Jun 5; 185:113-231.
Godoy ALPC, De Jesus C, De Oliveira ML, Rocha A, Pereira MPM, Larangeira DF, Lanchote VL, Barrouin-Melo SM. Determination of Allopurinol and Oxypurinol in Dogs Plasma by High-Performance Liquid Chromatography with an Ultraviolet Detector: Application for Pharmacokinetic Studies. J Chromatogr Sep Tech. 2017; 8 (4).
Clímaco EC, Oliveira ML de, Pitondo-Silva A, Oliveira MG, Medeiros M, Lincopan N, et al. Clonal complexes 104, 109 and 113 playing a major role in the dissemination of OXA-carbapenemase-producing Acinetobacter baumannii in Southeast Brazil. Infection, Genetics and Evolution. 2013 Oct;19:127–33.
Conference Papers:
Oliveira, M. L.; NARDOTTO, G. H. B.; PIPPA, L. F.; ROCHA, A.; SIMOES, B. P.; LANCHOTE, V. L. . Daunorubicin metabolism and urinary excretion in patients with acute myeloid leukemia. In: 84th Annual Meeting of the German Society for Experimental and Clinical Pharmacology and Toxicology (DGPT) and the 20th Annual Meeting of the Association of the Clinical Pharmacology Germany (VKliPha), 2018, Göttingen. Naunyn-Schmiedeberg’s Arch Pharmacol, 2018. v. 391. p. S76-S76.
Oliveira, M. L.; NARDOTTO, G. H. B. ; ROCHA, A. ; SIMOES, B. P. ; LANCHOTE, V. L. . The low contribution of urinary excretion in the elimination of daunorubicin and its metabolite daunorubicinol in patients with acute myeloid leukemia. In: 49th Brazilian Congress of Pharmacology and Experimental Therapeutics., 2017, Ribeirão Preto. Livro de Resumos, 2017. p. 64-64.
Oliveira, M. L.; PIPPA, L. F. ; ROCHA, A. ; SIMOES, B. P. ; LANCHOTE, V. L. . Quantification of daunorubicin and its metabolite daunorubicinol in human plasma by LC-MS/MS. In: I International Meeting of Environmental Health and Toxicology (IMEHTOX), 2016, Ribeirão Preto. Livro de Resumos, 2016.
Oliveira, M. L.; Clímaco, E.C. ; OLIVEIRA, M. G. ; Lincopan, N. ; Darini A.L.C. . PFGE typing of Carbapenem-Resistant Acinetobacter baumannii isolated from different University Hospitals. In: V International Postgraduate and Research Symposium, 2012.
Clímaco, E.C. ; SILVA, A. P. ; Oliveira, M. L. ; OLIVEIRA, M. G. ; Lincopan, N. ; Darini A.L.C. Relação clonal entre linhagens de Acinetobacter baumannii produtoras de carbapenemases da família OXA em quatro hospitais no Brasil. In: XXI Latin American Congress of Microbiology, 2012, Santos. XXI Latin American Congress of Microbiology, 2012.
Oliveira, M. L.; Clímaco, E.C. ; OLIVEIRA, M. G. ; Darini A.L.C. . Dissemintion of OXA carbapenemases genes in carbapenem-resistant Acinetobacter baumannii in University Hospital of Juiz de Fora, MG. In: 8th CIFARP – International Congress of Pharmaceutical Sciences, 2011, Ribeirão Preto.
Clímaco, E.C. ; Oliveira, M. L. ; OLIVEIRA, M. G. ; Darini A.L.C. . Avaliação do sequenciamento parcial do gene rpoB e de seus flanqueadores para identificação de espécies de Acinetobacter na rotina laroratorial. In: 2° International Symposium on Clinical Microbiology, 2010, Florianópolis.
You can view some of Dr Milena’s work below and links to her professional profile.
Linkedin: https://www.linkedin.com/in/dra-milena-locci-de-oliveira-28986042/?locale=en_US
ResearchGate: https://www.researchgate.net/profile/Milena-Oliveira-6
Escavador: https://www.escavador.com/sobre/5394254/milena-locci-de-oliveira
Lattes: https://buscatextual.cnpq.br/buscatextual/busca.do
Scopus: https://www.scopus.com/authid/detail.uri?authorId=57199779361
Scholar: https://scholar.google.com/citations?view_op=list_works&hl=pt-BR&user=1YUBDIQAAAAJ
In this article, we will explore the effects of Fluoxetine on urination. Furthermore, we will discuss related research findings, contributing factors, and what to do if Fluoxetine causes urinary problems.
Does Fluoxetine affect urination?
Fluoxetine may lead to changes in urination, by increasing urinary retention. However, it is not a common side effect. Some patients may experience urinary retention when taking higher doses of Fluoxetine or using it for an extended period.
Fluoxetine is an antidepressant belonging to the selective serotonin reuptake inhibitor (SSRI) class of drugs. Fluoxetine works by inhibiting the reuptake of serotonin, a chemical neurotransmitter in brain cells. Serotonin regulates sleep, appetite, mood, and the body’s stress response.
Fluoxetine is approved by the FDA to treat major depressive disorder (MDD), obsessive-compulsive disorder (OCD), panic disorder, eating disorders, bipolar depression, and treatment-resistant depression (in combination with Olanzapine).
Fluoxetine may also be used for post-traumatic stress disorder (PTSD), social anxiety disorder (SAD), and personality disorder (1). Urinary retention is a condition in which the patient is unable to fully empty the urinary bladder; often accompanied by lower abdominal pain (2).
However, it is important to note that not everyone taking Fluoxetine may experience urinary problems.
What does research suggest?
According to a research study, a patient had trouble urinating when he started Fluoxetine (20mg/day) and Resperidone (2mg/day). Fluoxetine may cause urinary retention in patients using it for depression and other related conditions, but it is a rare side effect.
This study suggests that urination difficulties may be associated with how serotonin functions in the brain. Therefore, Fluoxetine may cause urinary problems alone or when used in combination therapy (3).
Another case study reported urinary retention in a 15-year-old girl with post-traumatic stress disorder (PTSD) while taking Fluoxetine. She experienced difficulty urinating which occurred as a side effect of Fluoxetine.
She had to discontinue Fluoxetine due to this side effect, and her condition improved. In such cases, Sertraline, another antidepressant with a lower risk of causing urinary retention, may be considered (4).
What factors contribute to Fluoxetine-induced urinary problems?
Although urinary retention is a rare phenomenon while taking Fluoxetine, some factors may contribute to Fluoxetine-induced urinary problems. Some patients may be more sensitive to Fluoxetine based on their physiological response, making them more prone to urinary problems.
Taking a higher dose of Fluoxetine for an extended period can also increase the risk. Additionally, pregnant women and postpartum mothers may experience this side effect when taking Fluoxetine.
Elderly patients, who often have underlying health conditions and take concomitant medications, are at a higher risk of developing urinary retention when taking Fluoxetine (5). It is therefore important that your healthcare provider monitor and adjust the dosage according to your needs to minimize the risk of urinary retention.
What to do if Fluoxetine causes urinary problems?
If you observe any changes in your urine, such as dark colour, unusual odour, or a reduced volume of urine while taking Fluoxetine treatment, you should immediately inform your healthcare provider.
Urinary problems may occur in patients using antipsychotics, antidepressants, benzodiazepines, and NSAIDs. Your doctor will evaluate your current condition, symptoms, and family or medical history, and adjust the dosage of Fluoxetine.
If urinary retention persists with Fluoxetine, your doctor may switch you to another antidepressant such as Sertraline which has a lower risk of causing urinary retention and is effective in treating depression (4,5).
Conclusion
In my opinion, Fluoxetine can affect urination in some cases, however, it is not a common side effect. Factors such as higher doses, prolonged use, individual sensitivity, pregnancy, elderly patients, and use of concomitant medicine can contribute to the development of urinary problems while taking Fluoxetine.
If you experience urinary problems while taking Fluoxetine, you should immediately inform your healthcare provider. They will assess your condition and may adjust the dosage of Fluoxetine. If necessary, your doctor may switch you to another antidepressant with a lower risk of urinary problems.
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References
1.-
Sohel AJ, Shutter MC, Molla M. Fluoxetine. 2022 Jul 4. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan–. PMID: 29083803. Available from: https://pubmed.ncbi.nlm.nih.gov/29083803/
2.-
Billet M, Windsor TA. Urinary Retention. Emerg Med Clin North Am. 2019 Nov;37(4):649-660. doi: 10.1016/j.emc.2019.07.005. Epub 2019 Aug 16. PMID: 31563200. Available from: https://pubmed.ncbi.nlm.nih.gov/31563200/
3.-
Bozikas V, Petrikis P, Karavatos A. Urinary retention caused after fluoxetine-risperidone combination. J Psychopharmacol. 2001 Jun;15(2):142-3. doi: 10.1177/026988110101500201. PMID: 11448089. Available from: https://pubmed.ncbi.nlm.nih.gov/11448089/
4.-
Bulut ÖF, Karayağmurlu A, Kaya İ. Fluoxetine Related Urinary Retention in a 15-Year-Old Girl: a Case Report. Noro Psikiyatr Ars. 2022 Aug 16;59(3):246-247. doi: 10.29399/npa.27938. PMID: 36160069; PMCID: PMC9466638. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9466638/
5.-
Verhamme KM, Sturkenboom MC, Stricker BH, Bosch R. Drug-induced urinary retention: incidence, management and prevention. Drug Saf. 2008;31(5):373-88. doi: 10.2165/00002018-200831050-00002. PMID: 18422378. Available from: https://pubmed.ncbi.nlm.nih.gov/18422378/
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