Antipsychotic-induced urinary dysfunction: anticholinergic effect or otherwise?

Although urinary difficulties such as incontinence (UI) and retention (UR), reported with both typical and atypical antipsychotics, have been hypothesised as being a form of extrapyramidal side effects or due to anticholinergic side effects, we believe this may not be the case. We report here a male patient with bipolar disorder who developed urinary difficulties with antipsychotics, both typical and atypical, and in whom only aripiprazole seemed to work. We also hypothesise on the possible mechanisms of adverse urinary effects of antipsychotics.