SNRI-Induced Urinary Retention in a Young Male with Bodily Distress Disorder

Urinary retention (UR) is characterized by impaired bladder emptying and the presence of post-void residual urine. Certain medications, particularly those with anticholinergic or noradrenergic effects, can interfere with micturition pathways, leading to UR1, 2. This case report presents a 24-year-old male with recurrent drug-induced urinary retention caused by duloxetine and desvenlafaxine. The patient was first admitted in January 2023 with severe abdominal pain and low mood and diagnosed with Severe Bodily Distress Disorder. Treatment with duloxetine (40 mg) led to acute urinary retention within two days, requiring catheterization. Reducing duloxetine to 20 mg resolved the UR. After discontinuation and subsequent readmission in March 2023 with similar symptoms, initiation of desvenlafaxine (100 mg) again triggered urinary retention, necessitating catheterization. Uroflowmetry indicated a functional cause. Desvenlafaxine was cross tapered with sertraline, resulting in significant improvement without recurrence of UR. This case underscores the importance of careful medication selection and monitoring in patients susceptible to drug-induced urinary side effects.