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Suggest Treatment For Urinary Retention
Question: 73 y.o. male with paranoid schizophrenia has been on haldol and klonopin for many decades.
He has U.R. with resultant kidney failure (23% function left).
Would switching from Haldol to an Atypical antipsychotic reduce the U.R. and help the kidneys from further decline.
His bladder/ureters have been distended for 1.5 years. Does not have B.P.H. just lies in bed 99% of time.
Would taping the Klonopin help also?
He has U.R. with resultant kidney failure (23% function left).
Would switching from Haldol to an Atypical antipsychotic reduce the U.R. and help the kidneys from further decline.
His bladder/ureters have been distended for 1.5 years. Does not have B.P.H. just lies in bed 99% of time.
Would taping the Klonopin help also?
Brief Answer:
cannot be completely ruled out
Detailed Answer:
Hello,
Thank You for consulting HealthcareMagic!
Although urinary retention is a reported adverse event of Haldol, it cannot be assumed that this the cause of U.R. with resultant kidney failure in this patient. It is important to exclude all the possible causes of U.R. with resultant kidney failure by various investigations and thorough physical examination and follow ups, before considering the role of these drugs, haldol and klonopin. However, the role of Haldol cannot be completely ruled out.
If the diagnosis (the actual cause) is established through a thorough physical examination and appropriate investigations, then treatment would be much easier.
Stay healthy and thank you for consulting! You can contact me again anytime, if you need clarifications or further assistance in future. Kindly rate the answer if you are satisfied.
cannot be completely ruled out
Detailed Answer:
Hello,
Thank You for consulting HealthcareMagic!
Although urinary retention is a reported adverse event of Haldol, it cannot be assumed that this the cause of U.R. with resultant kidney failure in this patient. It is important to exclude all the possible causes of U.R. with resultant kidney failure by various investigations and thorough physical examination and follow ups, before considering the role of these drugs, haldol and klonopin. However, the role of Haldol cannot be completely ruled out.
If the diagnosis (the actual cause) is established through a thorough physical examination and appropriate investigations, then treatment would be much easier.
Stay healthy and thank you for consulting! You can contact me again anytime, if you need clarifications or further assistance in future. Kindly rate the answer if you are satisfied.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
He has had exams, C.T.'s etc. and they don't show anything wrong. I'm not assuming that Haldol or Klonopin are the cause. I am asking that if he is switched to an atypical antipsychotic would there be a chance of keeping him alive in that the atypical does not cause U.R. near as much as Haldol and would the switch possibly help to stop further kidney decline?
Brief Answer:
atypical anti-psychotics are also not safe
Detailed Answer:
Hi,
I can understand your concern. It is not that Haldol would definitely cause UR. It is a rarely reported side effect. If his treating doctor, based on all the previous physical examinations and follow ups strongly suspects that this can be the cause, then shifting to the other drug can be of help. Moreover, I personally think that atypical anti-psychotics are also not safe in patients with kidney function compromise. So, your treating doctor should decide based on the- benefits should outweigh risk approach.
Take Care!
atypical anti-psychotics are also not safe
Detailed Answer:
Hi,
I can understand your concern. It is not that Haldol would definitely cause UR. It is a rarely reported side effect. If his treating doctor, based on all the previous physical examinations and follow ups strongly suspects that this can be the cause, then shifting to the other drug can be of help. Moreover, I personally think that atypical anti-psychotics are also not safe in patients with kidney function compromise. So, your treating doctor should decide based on the- benefits should outweigh risk approach.
Take Care!
Above answer was peer-reviewed by :
Dr. Yogesh D
He is going to die if I don't, as his conservator, ask the doc to try something else.
He lacks capacity to give consent. Yes, I've read that atypicals are blackboxed for the elderly and there is an increased chance of stroke, diabetis etc.
What is the reason that you do not think that the atypicals aren't safe in pts. with kidney function compromise??
I know that they cost a lot more and Kaiser HMO doesn't like to spend money.
But since his bladder has been distended for so long and probably thick etc. I don't know if lessening the U.R. some would help?????
The pharmacist told me that Haldol is 80% more likely to cause U.R. than the atypicals.
The docs just want him to die but I don't believe in letting someone die if there are ways to keep them alive. The docs don't want to answer questions and i've gotten my info off of the internet.
He lacks capacity to give consent. Yes, I've read that atypicals are blackboxed for the elderly and there is an increased chance of stroke, diabetis etc.
What is the reason that you do not think that the atypicals aren't safe in pts. with kidney function compromise??
I know that they cost a lot more and Kaiser HMO doesn't like to spend money.
But since his bladder has been distended for so long and probably thick etc. I don't know if lessening the U.R. some would help?????
The pharmacist told me that Haldol is 80% more likely to cause U.R. than the atypicals.
The docs just want him to die but I don't believe in letting someone die if there are ways to keep them alive. The docs don't want to answer questions and i've gotten my info off of the internet.
Brief Answer:
atypical anti-psychotics should also be cautiously
Detailed Answer:
Hi,
As with many medications, atypical anti-psychotics should also be cautiously used in patients with kidney compromise according to clinical research studies conducted and literature search.
But since his bladder has been distended for so long and probably thick etc. I don't know if lessening the U.R. some would help?????
It does not work like that. Kidney failure if in end stage will not be reversible.
To comment more on your concerns, I need to do physical examination.
Take care!
atypical anti-psychotics should also be cautiously
Detailed Answer:
Hi,
As with many medications, atypical anti-psychotics should also be cautiously used in patients with kidney compromise according to clinical research studies conducted and literature search.
But since his bladder has been distended for so long and probably thick etc. I don't know if lessening the U.R. some would help?????
It does not work like that. Kidney failure if in end stage will not be reversible.
To comment more on your concerns, I need to do physical examination.
Take care!
Note: For further queries related to kidney problems and comprehensive renal care, talk to a Nephrologist. Click here to Book a Consultation.
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
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