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Effect of single doses of citalopram and reboxetine on urethral pressure: A randomized, double-blind, placebo- and active-controlled three-period crossover study in healthy women

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  1. Bladder dysfunction in advanced Parkinson's disease

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  2. Urethral Pressure Reflectometry Is Valuable for Evaluating Pharmacological Therapies for Stress Urinary Incontinence

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AIMS: Urethral closure function is essential for urinary continence in women and decreased urethral pressure is associated with stress urinary incontinence (SUI). For decades, the effects of serotonergic drugs on central neural control of urethral closure have been investigated and discussed. Epidemiological studies suggest that the use of selective serotonin reuptake inhibitors (SSRIs), such as citalopram, is associated with SUI. However, the literature findings are conflicting. This study aimed to evaluate citalopram's effect on opening urethral pressure (OUP) in healthy women.

METHODS: We conducted a randomized, double-blind, placebo- and active-controlled crossover study in 24 healthy women. On three study days, which were separated by 8 days of washout, the subjects received single doses of either 40 mg citalopram (and placeboreboxetine ), 8 mg reboxetine (and placebocitalopram ), or two placebos. Study drugs were administered at a 1-h interval due to a difference in estimated time to peak plasma concentration (tmax ). We measured OUP with urethral pressure reflectometry under both resting and squeezing conditions of the pelvic floor at estimated tmax for both study drugs (one timepoint).

RESULTS: Compared to placebo, citalopram increased OUP by 6.6 cmH2 0 (95% confidence interval [CI] 0.04-13.1, p = 0.048) in resting condition. In squeezing condition, OUP increased by 7.1 cmH2 0 (95% CI: 1.3-12.9, p = 0.01). Reboxetine increased OUP by 30.0 cmH2 0 in resting condition compared to placebo (95% CI: 23.5-36.5, p < 0.001), and 27.0 cmH2 0 (95% CI: 21.2-32.8, p < 0.001) in squeezing condition.

CONCLUSION: Citalopram increased OUP slightly compared to placebo suggesting that SSRI treatment does not induce or aggravate SUI.

Original languageEnglish
JournalNeurourology and Urodynamics
Issue number6
Pages (from-to)1482-1488
Number of pages7
Publication statusPublished - Aug 2022

Bibliographical note

© 2022 The Authors. Neurourology and Urodynamics published by Wiley Periodicals LLC.

    Research areas

  • Citalopram/adverse effects, Cross-Over Studies, Double-Blind Method, Female, Humans, Reboxetine/pharmacology, Serotonin Uptake Inhibitors/adverse effects, Urethra, Urinary Incontinence, Stress/drug therapy

ID: 79176024