Reply To: Urinary Retention (Delayed Urination)



Both of your concerns are related to mechanism of action of these drugs. All the drugs listed are are going to increase the levels of norepinephrine at the synapse, while the central effects of this are associated with increased focus, attention, and wakefulness, a possible peripheral effect is activation of adrenergic receptors on the trigone muscle on the neck of the urethra. The smooth muscle contracts and cause a decrease in the diameter of the urethra. All of the aphetamines and methylphenidate drugs will cause this. If you discontinue the medication urination should return to normal. It’s a tough situation because there isn’t much else out there that will treat ADD other than the amphetamines and methylphenidate. I’d suggest maybe exploring non pharmacological treatments if the urination is intolerable or maybe consulting your doctor and pharmacist about implementing a drug like Tamsulosin or Alfuzosin. These drugs are used to treat BPH by antagonizing the Alpha 1 receptors on the smooth muscle surrounding the urethra. I’m not familiar with any guidelines recommending this however and I would definitely discourage their use if you have hypotension.