hrvatski

Retencija urina povezana s malim dozama kvetiapina i natrijevog- valproata kod osobe starije životne dobi

Quetiapine is less likely to cause extrapyramidal side effects (EPS), compared to other antipsychotics. Despite the favourable safety profile associated with EPS, quetiapine increases the risk of orthostatic hypotension and the risk of falls. Furthermore, its anticholinergic effect can cause urinary retention and constipation. To the best of our knowledge, there has been no description of urinary retention at low doses of quetiapine during the first days of treatment. A man aged 83 was admitted to the Department of Biological Psychiatry and Psychogeriatrics via Emergency psychiatric Admission, presenting with a clinical picture of agitation as part or a dementia process. The patient has not been treated psychiatric so far. Heteroanamnestic data were obtained that the patient became forgetful a few years backwards, with decreased interest for the events and people around him, unappealing, suspicious, and a few months before the hospitalization intensely irritable, impulsive with elements of heteroaggressiveness towards the household. Psychotic features could not be ruled out. Tiny steps with a slight hands tremor were observed. On admission, routine laboratory tests are performed to detect elevated urea and anaemia. Upon arrival at the Department, quetiapine was administered at a dose of 12.5 mg / day, oxazepam at a dose of 20 mg daily, divided into two doses. On the third day of quetiapine administration, hypotension and instability occur during walking, so quetiapine was discontinued and sodium valproate was administered at 150 mg in the evening. Two days after quetiapine was discontinued, and on the second day after beginning of Na-valproate administration, urinary retention was observed and catheterization was required. Despite the low doses and slow titration of medications, especially with the use of antipsychotics in the elderly, extra caution is required. Careful monitoring of the general condition is recommended, and the side effects that may rarely occur in other populations should be kept ln mind with elderly. Although psychotic symptoms and aggressiveness have multiple adverse effects on the general psychophysical condition, it is necessary to balance the benefit-risk when using antipsychotics in the elderly, who are particularly sensitive to the development of side effects.

kvetiapin : Na-valproat ; retencija urina ; starije osobe

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