Risperidone-Induced Urinary Incontinence in the Elderly

Introduction to Risperidone-Induced Incontinence

The American Geriatrics Society recommends that clinicians consider the potential for risperidone to cause urinary incontinence in elderly patients, particularly those with pre-existing comorbidities such as benign prostatic hyperplasia, due to its anticholinergic effects 1, 2

Polypharmacy, common in elderly patients, can potentiate the effects of risperidone on urinary function through drug interactions, increasing the risk of incontinence 1, 2
Physiological changes associated with aging, such as decreased bladder capacity and reduced muscle tone, increase vulnerability to risperidone-induced incontinence 3, 4

The American Geriatrics Society suggests evaluating the temporal relationship between the initiation of risperidone and the onset of incontinence symptoms, and considering dose adjustment or switching to another antipsychotic with a lower anticholinergic profile 1, 5
Identifying and treating underlying causes of incontinence that may be exacerbated by risperidone, such as urinary tract infections, fecal impaction, and mobility restrictions, is crucial 1, 5

Urinary incontinence has a profound impact on the quality of life of elderly patients, potentially leading to social isolation, depression, falls, and fractures, highlighting the need for proactive management 1, 5

Screening for urinary incontinence symptoms before initiating risperidone in elderly patients is recommended to identify those at higher risk 1