Does Pristiq Cause Bladder Problems? (3+ Risk Factors)

In this article, we will discuss whether Pristiq causes bladder problems. We will share what bladder problems Pristiq can cause, the possible mechanism of the bladder issues caused by Pristiq, and what are some risk factors that increase the risk of Pristiq-induced bladder issues. 

Does Pristiq cause bladder problems? 

Yes, Pristiq can cause bladder problems in some individuals. Although it is not an officially documented side effect of Pristiq, in some individuals taking Pristiq, bladder issues have been observed. Bladder problems are not frequently reported with this drug. 

Pristiq is the brand name for desvenlafaxine which is a serotonin-norepinephrine reuptake inhibitor (SNRI). It is an antidepressant and FDA-approved drug for major depressive disorder (MDD). 

The bladder problem which has been reported in some patients taking Pristiq is urinary retention. Urinary retention is a condition where the individual is unable to empty their bladder completely which results in urine accumulation (1). 

Urinary retention can be identified by symptoms like frequent urination, waking up at night due to the need to urinate, a weak stream, and a strong urge to urinate followed by an inability to postpone urination (1). 

Urinary retention is not a frequently reported side effect of Pristiq although some cases are reported. You must contact your healthcare provider if you experience this bladder problem while taking Pristiq. 

How does Pristiq cause bladder problems?

The bladder problem associated with Pristiq is urinary retention. Urinary retention of Pristiq is caused by its effects on serotonin and norepinephrine (NE). Pristiq increases the concentration of these neurotransmitters. 

Onuf’s nucleus is a group of nerve cells present in the sacral region of the spinal cord. Onuf’s nucleus controls the external urinary sphincter and consists of serotonin and NE receptors (1). 

Serotonin contributes to the process of urine storage and inhibits the parasympathetic pathway of bladder emptying. An increase in serotonin by Pristiq further enhances this action (1). 

Activation of the receptors of NE in the Onuf’s nucleus and the internal urethral sphincter is linked to urinary retention. Thus, Pristiq can cause urinary retention by increasing serotonin and NE levels in the body (1). 

What does research suggest?

Different studies have been carried out to evaluate the efficacy and safety of desvenlafaxine, the generic of Pristiq. A randomized controlled trial mentions that one patient receiving a 10 mg/day dose of desvenlafaxine developed urinary retention (2). 

A 10-month study was conducted to study the long-term safety of desvenlafaxine. Patients received desvenlafaxine at doses ranging from 200-400mg/day. 3 patients in this study complained of urinary retention (3). 

A systematic review included 52 studies to study the impact of psychotropic drugs on bladder function. The results revealed that SNRIs like Pristiq were associated with bladder voiding disorders like urinary retention (4). 

What factors increase the risk of Pristiq-induced bladder problems?

Different factors increase the risk of bladder problems like urinary retention in individuals. The risk is exacerbated when these individuals take Pristiq. The risk factors for urinary retention include (5,6). 

Bladder outlet obstruction: 

An obstruction that blocks the outflow of urine increases the risk of urinary retention. It can occur if the urethral channel is physically narrowed or muscle tension in and around the urethra increases (5). 

Different conditions can cause bladder outlet obstruction. They include (5,6):

• constipation 
• urethral stricture
• fibroids
• tumor mass 
• urolithiasis 

Age: 

As the age increases, the bladder muscles are weakened and the ability of an individual to sense that their bladder is full also reduces. The urinary flow rate is also decreased and the amount of urine left in the bladder after urination increases (6). 

These gradual changes associated with ageing increase the risk of urinary retention. Thus older adults taking Pristiq are at higher risk of developing bladder problems. 

Health conditions: 

Individuals with different health conditions are at higher risk of developing urinary retention while taking Pristiq. These conditions include (5,6):

• prostatitis
• urethritis
• urethral edema
• cervical cancer
• diabetes
• Fowler’s syndrome
• genital herpes

Other medications: 

Different medications increase the risk of bladder problems like urinary retention. Taking these medications along with Pristiq increases the risk of bladder problems. The medications include (5).

• alpha-adrenergic agents e.g. phenylephrine and ephedrine sulphate
• beta-adrenergic agents e.g. terbutaline
• antiarrhythmics e.g. quinidine
• anticholinergics e.g. atropine and scopolamine 
• antipsychotics e.g. haloperidol and thioridazine 
• antihistamines
• antihypertensives

How are Pristiq-induced bladder problems managed? 

If you experience symptoms of bladder problems while taking Pristiq, immediately contact your healthcare provider. Do not stop taking the drug abruptly as it can cause withdrawal symptoms. Do not cut the medication in half for dose reduction. 

Your healthcare provider may reduce the dose of Pristiq if you experience bladder problems. If symptoms are not resolved, your healthcare provider may switch to another medication. 

Bladder problems like urinary retention are usually managed by urinary catheterization. It involves inserting a tube (catheter) into the bladder which allows the urine to flow out. 

Bladder problems like urinary retention can be resolved easily with treatment. Therefore you must communicate with your healthcare provider if you experience any symptoms related to urination. 

What are some tips to keep your bladder healthy while taking Pristiq? 

You can use the following tips to keep your bladder healthy and avoid bladder problems while taking Pristiq. 

• do not hold urine for too long as it can make your bladder muscles weak
• allow the bladder to empty completely and do not rush urination
• include exercise in your daily routine as it allows you to maintain a healthy weight and prevents constipation and bladder problems
• maintain adequate hydration which keeps the bladder healthy and  also prevents constipation
• avoid caffeine, alcohol, spicy foods, and sodas as they can exacerbate bladder problems.
• always tell your healthcare provider about every medication you are taking and if you have a history of bladder problems. 

In my perspective, Pristiq can cause bladder problems like urinary retention in some individuals. Although it is not an officially documented side effect, some patients have experienced urinary retention while taking Pristiq. Pristiq increases the levels of serotonin and NE which activates receptors in the urethral sphincter which contributes to urinary retention. Certain risk factors like bladder outlet obstruction, age, health conditions, and other medications exacerbate the chance of bladder problems while taking Pristiq. Urinary retention caused by Pristiq can be managed by dose reduction, switching to another drug, and urinary catheterisation. 

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