Seroquel & Difficulty Urinating?

[Alisonlg]

Any info on difficulty urinating? We just upped M's dose from 200 mg a day to 400 mg a day yesterday and all of a sudden today he can't pee. Called his pediatrician and she said to give him a warm bath and if that doesn't help, to bring him to the ER. :::: Meltdown, here we come! He's dribbled here and there, but nothing much. He can't completely empty.

He did go a *little* more than a dribble last time he tried (but still could not empty), but since I've had him drink a big glass of gatorade to stay hydrated (we spent quite a few hours in the sun this afternoon), so we'll see if he can pee that out in the next hour. If not, I guess we're headed to the ER in meltdown mode.

I can't find anything about Seroquel causing difficulty urinating...yet I find it an odd coincidence.

 

[smallworld]

My son has had problems every so often with a feeling of urinary urgency but then not being able to void. He is not on Seroquel, but his psychiatrist said it could very well be from some of the medications he takes. If the problem persists, I would definitely recommend seeking medical attention.

 

[Alisonlg]

He's peeing again. Thank goodness! I was NOT looking forward to spending the night in the ER!

Going to see how he does tomorrow. Today has been a long day.

 

[Alisonlg]

The difficulty urinating returned today, around the same time and now it sounds like he has a Urinary Tract Infection (UTI). :frown:

I'm totally confused as to whether this is a direct result of the increase in the Seroquel (quite the coincidence) or if it truly is a coincidence or perhaps the Seroquel acted as a catalyst to set off something else he already has going on (he's had a few mysterious urinary tract issues in his lifetime- a couple Urinary Tract Infection (UTI)'s which they say are VERY unusual for a boy his age and one ER trip for an un-diagnosis'd issue- I suspect it was a kidney stone....ALSO vERY unusual for an 8 yr old boy).

Nonetheless, I don't know what to do. It's Memorial Day Weekend and I'm sure the pediatrician's office isn't open until Tuesday. AGH!

 

[Sara PA]

Urinary retention is listed as an "infrequent" side effect for Seroquel. Oddly it's listed as a Nervous System adverse reaction. Urinary frequency is listed under Urogenital System adverse reactions. Go figure.

 

[Alisonlg]

Perhaps it's a reaction to the Strattera??? He's been on that for about 4-ish weeks now and we haven't touched the dosage, but I've recently read it takes a few weeks to reach it's potential in the body.

"Difficulty urinating" is on the Strattera side effects list and says to call your Dr as soon as possible...but I don't know what the Dr would tell you to do. I mentioned BOTH medications to our pediatrician and she just said if he didn't pee to take him to the ER...he's intermittently able to pee, so he's not totally blocked...but just recently seemed to develope the Urinary Tract Infection (UTI), so we WILL have to get that treated before Tuesday so it doesnt' go up to his kidneys.

UGH. Hate this.

 

[Steely]

How do you know it is a Urinary Tract Infection (UTI), did you go the ER, or is it just the mothers instinct we all have? I only ask because I was confused as to whether you went to the ER or not. If it is yet to be diagnosed, can you go to a doctor in the box to get some antibitocs? I am a lifelong sufferer of UTIs, and have had man bouts of kidney stones, so my sympathy is with you and your son. Also, could you lower the dose of Seroquel to see if that helps?

Good luck!

 

[Alisonlg]

We have not yet gone to the ER. He is now saying that when he IS able to go, it hurts...so, I'm *guessing* this stored urine is causing a bladder infection.

Forgive me if I sound stupid, but what is a doctor in the box?

After the "encounter" we had with the psychiatrist, I am ashamed to admit that I'm both scared to call him and scared to decide on my own to lower the dose of Seroquel. :frown: And let me just say that if it turns out to be the darn Strattera, I will kick myself and then crawl under a rock because that jerk psychiatrist wanted to take M off of it on Thursday and I was the one who asked to keep him on it. :frown: I swear, just for THAT, I'd have to definately change psychiatrists!

 

[Steely]

Oh gosh....I am sorry. I realized after I typed that last email, that maybe "doctor in the box" is a Texas term.......God know we have enough of those!!! Anyway......that term applies to like a Prima Care, or one of those places that has doctors all days of the week and is open to all people...I am not sure what they would be called in CT, but they could basically give your son some antibiotics unil you could see your regular Dr. I would hate for him to wait until Tues to get them, because by then it could move into his kidneys - and beside it HURTS!

As far as the medications.....I know nothing about Strattera, but I know a lot about Seroquel. Of course, these are MY personal experiences, so please take them as just opinions. My thought is that to jump your boys Seroquel by 200mg is pretty outrageous. That is ALOT! I don't know how big your boy is, but my son is 6'2 and if I had increased his Seroquel by 200 in one dose, it would have knocked him out. That said, it is really not a big deal to back off a little if you so choose. The worst that can happen is that he is less sedated, but it would be worth a try to see if these urinary problems decrease. Usually a doctor suggests increasing this medication by increments of 50 mg, at least that is my experience. Even when my son was just in psychiatric hospital, they did not give him more than 100 as a PRN. I just can't help but think it is the Seroquel - but again, that is my opinion.

Let me know how it goes..........I am thinking good thoughts.

 

[smallworld]

Alison, I wouldn't wait until Tuesday if you suspect a Urinary Tract Infection (UTI). There is something here called Nighttime Pediatrics -- do you have something similar where you live? If not, you definitely should head to the ER. UTIs can have serious consequences if not treated quickly.

 

[Alisonlg]

It took all I had this morning to place a call to the psychiatrist just to get his opinion before I head over to the ER...it's been 40 minutes and still haven't gotten a call back. Lovely.

So far he can pee this morning and he's saying it doesn't hurt, but the difficulty peeing doesn't usually kick in until the afternoon. And he has such a high tolerance for pain, him saying it doesn't hurt now doesn't necessarily mean all is OK...especially if it hurt last night (and THAT is NOT a side effect symptom of either medication).

We have no Nighttime Pediatrics or doctor in a Box's around here...the closest would be a Urgent Care facility about 1/2 hr-45 minutes away, in which case I'd much rather get a full work up at the local ER where perhaps he can see a Urologist to address the potential of deeper issues.

 

[Alisonlg]

I swear that psychiatrist is a jerk. 3 hours and still no return call. GRRRR... Well, we're off to the ER. Happy, Happy, Joy, Joy!

 

[smallworld]

Alison, the psychiatrist may be a jerk, but honestly, it's a holiday weekend, and your difficult child is not having a mental health crisis. I don't think it's unreasonable that he hasn't returned your call in 3 hours. I know our psychiatrists (who are very, very responsive) don't call back within hours if it's not a mental health emergency. Even if he had called you back, he'd be sending you somewhere to get your difficult child evaluated for a Urinary Tract Infection (UTI) because he can't do that evaluation himself.

Hope you get some answers at the ER.

 

[Alisonlg]

Back from the ER with no answers. :frown:

They don't think it's the Seroquel or the Strattera...they think it's "stress" :::rolls eyes:::

They dipped the few drops of urine he was able to grunt out over the course of the two hours we were there and they were clear of a Urinary Tract Infection (UTI)...so no clue what the pain upon urination is from. They are, however sending out the sample I brought from home for cultures, which should take 2 days.

So, it looks like my son is going to continue to suffer with not being able to pee, and pain when he is finally able. :frown:

 

[Steely]

Oh man.....I am SO sorry! Stress? That is a weird response from the doctors. - hmmmmm...........

Well, I guess hang on, and wait for the psychiatrist to call. At least you know it is not an infection. Just for the record - in my experience all doctors say,
"Oooohhh.........i don't think it is the medications causing XY or Z." :cry:
Case and point my son's cholestrol problems on Seroquel!!! Ugh...it is frustrating, but I guess you have to go with your gut. Especially since when you researched the medication, you found evidence it can cause urinary retention.

Good Luck!

 

[Sara PA]

What's their basis for believing it's not related to the medication when both medications have urination problems as listed side effects? I would consider that it might be the combination of the two drugs.

 

[Alisonlg]

Who knows what their basis is. The psychiatrist never called me back and the ER did nothing more than push on his belly, dip his urine, and scan his bladder to measure the amount of urine he was storing and send us home. I just know it's the medications, I just don't know which one and I would like to involve the psychiatrist on the decision to either stop the Strattera and see if that helps or to cut back on the Seroquel. :::: My poor kiddo.

 

[smallworld]

Alison, if the new psychiatrist doesn't call you back by Tuesday, can you consult with a psychiatrist at the day treatment program about the medications? If you end up decreasing medications, I'd strongly encourage you to only make one medication change at a time. Otherwise, you have no idea what medication is doing what.

 

[oceans]

Is the new psychiatrist linked with a university or hospital? There are usually other psychiatrists on call for emergencies during weekends and holidays.

 

[Alisonlg]

sw- I would certainly only touch ONE of the drugs...not both! :wink: I think what I'm going to do tonight is titrate the Seroquel down to 300 mg a day from the increased 400 mg a day (so, instead of giving him 200 mg tonight, I'm going to give him 150 mg...same thing in the morning) and see if that helps with the difficulty urinating.

Unless the Seroquel could have aggrivated the Strattera, I'm going to assume it's the Seroquel causing the problem.