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Paliperidone palmitate-induced enuresis: a case report

Published online by Cambridge University Press:  01 September 2022

S. Cruz ,
N. Cunha E Costa ,
A. Morais ,
M. Mendonça ,
R. Trindade  and
S. Xavier
S. Cruz*
Affiliation:
Hospital Garcia de Orta, Almada, Psychiatry, Almada, Portugal
N. Cunha E Costa
Affiliation:
Hospital Garcia de Orta, Almada, Psychiatry, Almada, Portugal
A. Morais
Affiliation:
Hospital Garcia de Orta, Almada, Psychiatry, Almada, Portugal
M. Mendonça
Affiliation:
Hospital Garcia de Orta, Almada, Psychiatry, Almada, Portugal
R. Trindade
Affiliation:
Hospital Garcia de Orta, Almada, Psychiatry, Almada, Portugal
S. Xavier
Affiliation:
Hospital Garcia de Orta, Almada, Psychiatry, Almada, Portugal
*
*Corresponding author.

Abstract

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Introduction

Schizophrenia is a severe mental illness that requires long-term treatment with antipsychotics and the intramuscular (IM) long-acting injectable (LAI) formulations may enhance treatment adherence. Some antipsychotics have been associated with enuresis, including atypical antipsychotics such as risperidone(6.2%), quetiapine(6.7%), olanzapine (9.6% ) and clozapine (20.7%) [1]. Although oral paliperidone has been related to urinary incontinence, there is only 1 report of urinary incontinence linked to monthly paliperidone palmitate [2]. [1] Harrison-Woolrych, M., Skegg, K., Ashton, J., Herbison, P., Skegg, D.C., 2011. Nocturnal enuresis in patients taking clozapine, risperidone, olanzapine and quetiapine: comparative cohort study. British Journal of Psychiatry 199, 140–144. doi:10.1192/bjp.bp.110.087478 [2] Karslıoǧlu, E.H., Özalp, E., Çayköylü, A., 2016. Paliperidone Palmitate-induced Urinary Incontinence: A Case Report. Clinical Psychopharmacology and Neuroscience 14, 96–100. doi:10.9758/cpn.2016.14.1.96

Objectives

To establish an association between paliperidone palmitate and enuresis.

Methods

Case report and a narrative review of the literature.

Results

The patient was a 25-year-old healthy man when he was diagnosed with schizophrenia. Doctors prescribed paliperidone palmitate (LAI) 200mg monthly and he started to complain of enuresis. He was clearly suffering with this unpleasant and embarrassing adverse effect so the LAI was reduced to 150mg. Enuresis remained, so it was prescribed oxybutynin 20 mg/day and the patient improved.

Conclusions

We reported a case in which enuresis is likely to be associated with high-dose paliperidone LAI (with no clinical evidence of an organic cause). To treat it, the most effective strategy was oxybutynin 20 mg/day. This case is also important to show the impact of this symptom, which is not actively investigated.

Disclosure

No significant relationships.

Keywords

paliperidoneschizophréniaenuresis
Type
Abstract
Information
European Psychiatry , Volume 65 , Special Issue S1: Abstracts of the 30th European Congress of Psychiatry , June 2022 , pp. S798
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of the European Psychiatric Association
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