Managing OCD Treatment: Addressing Urinary Retention and Alternatives

Treatment for Obsessive-Compulsive Disorder (OCD)

Hello: I have recently been taking medication for the treatment of obsessive-compulsive disorder (OCD), and after taking it, I feel like I have urine that I cannot fully expel.
The urologist mentioned that if the bladder does not empty completely, it could lead to bladder inflammation or stones.
My psychiatrist said that medications for OCD can potentially cause urinary retention.
I have taken Zoloft and Prozac, both of which made me feel like I had urine that was not fully expelled.
May I ask: 1.
Should I continue to try different medications until I find one that suits me? 2.
Is it possible to treat this condition using non-pharmacological methods? 3.
Can you recommend a good psychiatrist in Taipei?

Xiao Ming, 30~39 year old female. Ask Date: 2009/04/30

Dr. Zheng Jingming reply Psychiatry

The pharmacological action of antidepressants lies in the inhibition of serotonin reuptake, which leads to an increase in serotonin concentration in the synaptic cleft.
Sometimes, there may be side effects such as urinary retention.
It is advisable to discuss suitable medications with your attending physician during your outpatient visit.
The most effective approach for obsessive-compulsive disorder (OCD) is a combination of antidepressants and cognitive-behavioral therapy (CBT).
While pure CBT is effective, it does not yield results as favorable as when both treatments are used concurrently.
It is recommended to seek regular outpatient treatment from a dedicated psychiatrist.
For any treatment-related issues, try to discuss them with your outpatient physician.
In terms of treating OCD, psychiatrists in specialized psychiatric hospitals or the psychiatry department of general hospitals should be well-equipped to assist.
Zheng Jingming

Reply Date: 2009/04/30

More Info

Managing obsessive-compulsive disorder (OCD) can be a complex process, especially when medications used to treat the condition lead to side effects such as urinary retention. It’s important to address both the psychological and physiological aspects of your situation.

1. Medication Adjustment: It is common for selective serotonin reuptake inhibitors (SSRIs) like Zoloft (sertraline) and Prozac (fluoxetine) to cause urinary retention in some patients. If you are experiencing this side effect, it is crucial to communicate this with your psychiatrist. They may consider adjusting your dosage or switching you to a different medication that may not have this side effect. It’s not uncommon for patients to go through several medications before finding the one that works best for them without intolerable side effects. However, it’s essential to do this under the guidance of your healthcare provider to ensure safety and efficacy.

2. Non-Pharmacological Treatments: Yes, there are non-drug therapies available for OCD that can be effective. Cognitive-behavioral therapy (CBT), particularly exposure and response prevention (ERP), is considered the gold standard for treating OCD. This therapeutic approach helps patients confront their fears and reduce compulsive behaviors without resorting to medication. Mindfulness and relaxation techniques can also be beneficial in managing anxiety associated with OCD. Additionally, support groups or therapy focused on coping strategies can provide valuable assistance. Discuss these options with your psychiatrist or a psychologist who specializes in OCD treatment.

3. Finding a Specialist: If you are looking for a reputable psychiatrist in Taipei, I recommend seeking out professionals who specialize in anxiety disorders and OCD. You can start by checking with local hospitals or mental health clinics that have a good reputation. Websites such as the Taiwan Psychiatric Association may also provide directories of qualified professionals. Personal recommendations from friends or family can also be helpful.
In terms of your urinary retention concerns, it’s essential to monitor your symptoms closely. If you experience significant discomfort, difficulty urinating, or signs of a urinary tract infection (such as fever, chills, or blood in urine), seek medical attention promptly. Your urologist may suggest interventions such as bladder training exercises, pelvic floor therapy, or in some cases, medications that can help alleviate urinary retention.

In summary, managing OCD while dealing with side effects like urinary retention requires a collaborative approach between your psychiatrist and urologist. Open communication about your symptoms and treatment preferences is key. Exploring both medication adjustments and non-pharmacological therapies can help you find a balanced treatment plan that addresses both your mental health and physical well-being. Always consult with your healthcare providers before making any changes to your treatment regimen.

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