Urinary Incontinence Side Effects Due to Sertraline Use: A Literature Review

Introduction: Sertraline is a psychotropic medication in the SSRI class that is widely used due to its ability to treat depression, anxiety, PTSD, and OCD. Along with its therapeutic effects, sertraline is known to frequently cause gastrointestinal and sexual side effects. However, urinary tract side effects are infrequently reported. Methods: The design applied in this study is a literature review. The literature review was conducted using online databases such as PubMed, Google Scholar, and ScienceDirect. Six journals that met the inclusion criteria were identified. Results: The pathophysiology of sertraline-induced urinary incontinence is not yet fully understood. It is suspected that sertraline activates serotonergic pathways, which may enhance cholinergic transmission in the detrusor muscle, and activates dopaminergic pathways, which stimulate urination. Urinary incontinence was reported during the initial use of sertraline and in some cases with dose escalation. The symptoms disappeared with dose reduction or discontinuation of the medication. Discussion: Sertraline works by blocking α-adrenergic receptors and inhibiting dopamine reuptake. Blockade of α-adrenergic receptors leads to a decrease in the tone of the internal urinary sphincter, and inhibition of dopamine reuptake results in reduced urethral sphincter activity. Rather than directly administering an effective dose, clinicians are advised to consider starting therapy with a low dose and gradually increasing it. Conclusion: Urinary incontinence is an uncommon side effect of sertraline. However, clinicians should consider prescribing sertraline with caution, as the side effects may reduce patients’ quality of life and adherence to treatment.