Pulmonary embolism from persistent dilatation of the bladder secondary to anticholinergic side effects.

Abstract

OBJECTIVE:

To discuss the risk that bladder distention resulting from anticholinergic side effects of antipsychotics can cause iliac vein compression syndrome (IVCS) and subsequent pulmonary embolism (PE).

METHOD:

Case report, review of the literature and discussion.

RESULTS:

We report the case of a 65-year-old man with depression who experienced PE associated with IVCS due to a distended urinary bladder resulting from anticholinergic side effects. PE disappeared after conservative therapy with heparin followed by warfarin.

CONCLUSION:

When drugs with anticholinergic effects are given to immobilized patients such as those with severe depression, close observation including monitoring of urine volume is needed to prevent IVCS caused by drug-induced urinary retention, and subsequent PE.

• Authors: Masanobu Ito, Kotaro Hatta, Koichi Miyakawa, Heii Arai
• Journal: General hospital psychiatry (Gen Hosp Psychiatry) 2009 Mar-Apr Vol. 31 Issue 2 Pg. 187-9 ISSN: 1873-7714 [Electronic] United States
• PMID: 19269543 (Publication Type: Case Reports, Journal Article)

Chemical References

• Antidepressive Agents
• Cholinergic Antagonists
• Chlorpromazine

Topics

• Aged
• Antidepressive Agents (therapeutic use)
• Chlorpromazine (therapeutic use)
• Cholinergic Antagonists (adverse effects)
• Depressive Disorder, Major (drug therapy, psychology)
• Dilatation, Pathologic (chemically induced, complications)
• Humans
• Male
• Pulmonary Embolism (etiology)
• Urinary Bladder Diseases (chemically induced, complications)
• Urinary Retention (chemically induced, complications)