Pulmonary embolism from persistent dilatation of the bladder secondary to anticholinergic side effects.
OBJECTIVE
To discuss the risk that bladder distention resulting from anticholinergic side effects of antipsychotics can cause iliac vein compression syndrome (IVCS) and subsequent pulmonary embolism (PE).


METHODS
Case report, review of the literature and discussion.


RESULTS
We report the case of a 65-year-old man with depression who experienced PE associated with IVCS due to a distended urinary bladder resulting from anticholinergic side effects. PE disappeared after conservative therapy with heparin followed by warfarin.


CONCLUSIONS
When drugs with anticholinergic effects are given to immobilized patients such as those with severe depression, close observation including monitoring of urine volume is needed to prevent IVCS caused by drug-induced urinary retention, and subsequent PE.
Ito
Masanobu
M
Department of Psychiatry, Juntendo University School of Medicine, Tokyo, Japan. masa110@med.juntendo.ac.jp
Hatta
Kotaro
K
Miyakawa
Koichi
K
Arai
Heii
H
D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use; D002746:Chlorpromazine / Q000627:therapeutic use; D018680:Cholinergic Antagonists / Q000009:adverse effects*; D003865:Major Depressive Disorder / Q000188:drug therapy / Q000523:psychology; D004108:Dilatation, Pathologic / Q000139:chemically induced* / Q000150:complications*; D006801:Humans; D008297:Male; D011655:Pulmonary Embolism / Q000209:etiology*; D001745:Urinary Bladder Diseases / Q000139:chemically induced* / Q000150:complications*; D016055:Urinary Retention / Q000139:chemically induced* / Q000150:complications*
D000928:Antidepressive Agents; D018680:Cholinergic Antagonists; D002746:Chlorpromazine