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Example sentences for: micturition
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Clozapine is a widely used atypical neuroleptic with affinity for multiple receptors, including dopamine, serotonin, alpha adrenergic, muscarinic and histaminergic receptors [ 1 2 ] . Although clozapine is effective in the treatment of schizophrenia refractory to traditional antipsychotic medication, it also has a number of significant side effects ranging from the potentially fatal but rare agranulocytosis to weight gain, constipation, seizures and urinary incontinence [ 3 ] . Urinary problems have been reported in the clinical literature with incontinence present in up to 44% of patients [ 4 ] and enuresis in 27% of patients [ 5 ] . Since clozapine has potent anti-muscarinic and anti-alpha adrenergic effects [ 2 ] , it has been proposed that peripheral effects on the lower urinary tract might be responsible for the micturition disturbances [ 6 ] . Incontinence has also been reported following therapy with other atypical neuroleptics such as risperidone [ 7 8 9 ] and recently, olanzapine [ 10 ] .
The following parameters were examined from the cystometrogram as described in detail earlier [ 7 ] : bladder capacity (amount of fluid infused to elicit a contraction); micturition volume (amount of fluid expelled); residual volume ([bladder capacity - micturition volume]/ [bladder capacity]); pressure threshold (pressure at which contraction begins); peak pressure (maximal pressure during contraction); contraction time; expulsion time (time between peak pressure and end of high frequency oscillations); amplitude of high frequency oscillations.
Therefore, central effects of clozapine in controlling micturition volume are likely.
The exact receptor types (or combination of receptor types) responsible for clozapine's central effects on micturition were not investigated in the present study.
In anesthetized rats, doxazosin (alpha 1 adrenergic receptor antagonist) administered systemically, increased micturition volume, bladder capacity, residual volume and micturition frequency while decreasing peak pressure [ 36 ] . Only an increase in the micturition frequency was observed after spinal administration of doxazosin [ 37 ] . Both olanzapine and risperidone have moderate affinity for the alpha 1 adrenergic receptor (Table 1), therefore it is possible that some of the effects observed in the present study were due to central and/or peripheral antagonism of alpha 1 adrenergic receptors by these drugs.
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