造成尿液滯留的原因有很多，最常見的原因是攝護腺肥大(約占70%尿液滯留的原因)。在臨床上，可以看到有些正在服用抗精神病藥物或抗憂鬱症藥物的患者，即使沒有明顯病因，也會造成尿液滯留。過去的研究指出，此類由藥物所造成之尿液滯留的比例約為2%。此篇文章就是在回顧並提供”尿液滯留”與”抗精神病藥物或抗憂鬱症藥物”之間的關聯性。

本篇文章搜索的資料庫範圍包含：Scopus, Pubmed, Web of Science, Cochrane library。搜索的詞彙為 urinary retention(尿液滯留), antidepressant(抗憂鬱症藥物), antipsychotics(抗精神病藥物)。總共搜索到614篇相關的文獻，排除非英文的文章、動物實驗研究、無全文、設計不良的實驗等等。最後有38篇入選並接受進一步分析。而在這38篇當中，有1篇綜合性分析(meta-analysis)，5篇隨機分析試驗(randomized control trial)，5篇追蹤性研究(cohort study)，27篇案例報告(case report)。 文獻回顧分析結果發現：哲思(ziprasidone，一種非典型抗精神病藥物)，產生尿滯留的機會約4.7%。妥富腦(imipramine，屬於三環抗憂鬱劑的一種)，產生尿滯留的機會約7.6%；但是，整體的三環抗憂鬱劑(tricyclic antidepressant) 產生尿滯留的機會只有0.1%。選擇性血清素回收抑制劑(selective serotonin reuptake inhibitor)，產生尿滯留的機會約0.025%。正腎上腺素回收抑制劑(noradrenalin reuptake inhibitor)，與典型的抗精神病藥物都有導致尿液滯留的機會，但是在此類的研究中，缺乏對於尿液滯留的定義。千憂解(duloxetine，一種合併血清素與正腎上腺素回收抑制劑)，沒有發現產生尿液滯留的患者。

調控人體排尿的機制相當複雜，牽涉到許多神經與肌肉的協調，在這當中又有許多身體激素的參與，如乙醯膽鹼(acetylcholine)、多巴胺(dopamine)、血清素(serotonin)、正腎上腺素(noradrenaline) 、鴉片(opioid)、 γ-胺基丁酸(gama amino butyric acid)等等。藥物在作用時會干擾這些激素的代謝，導致尿液滯留。本篇文章列舉各種抗精神病藥物與抗憂鬱症藥物的尿滯留發生機率，並探討其可能的藥理機轉，不管是對於正在服用此類藥物的患者，或者是開立處方的醫師，都是一份寶貴的實證醫學資訊。在臨床應用上，除了考慮藥物本身的因素之外，還必須要考慮病患身體的因素：是不是年紀太大、已經有服用治療攝護腺的藥物、合併中風或周邊神經損傷、肝腎功能是否不好、、、等等。才可以避免發生尿液滯留。所幸 文章也有提到，絕大多數病患若因藥物而造成尿液滯留，只需要把藥物停掉，便會恢復排尿。此篇文章也有一些限制：在尿液滯留的定義上，有許多文獻並未提及或者有統一的標準；在文獻的組成中，其異質性高，產生實驗偏差的機會亦較高。

Aims: Urinary retention (UR) occurs in patients on antipsychotic and antidepressant medication despite no apparent underlying urological cause. This review was undertaken to ascertain which of these medications are associated with URand how often.

Methods: A systematic literature search for evidence on antipsychotic and antidepressant medications and UR was completed in June 2015 using Scopus, Pubmed, Web of Science, and the Cochrane library. Search terms included urinary retention, antidepressants and antipsychotics as well as individual drug names. Filters used were: humans and English language. PRISMA guidelines were employed. Results: Out of 614 articles initially identified, one meta-analysis, five RCT’s, five cohort studies and 27 case reports were finally included. There was a wide range ofdefinitions of UR. Studies which appropriately defined UR revealed it occurred in 1/21 patients on ziprasidone (an atypical antipsychotic), 17.6% of those on imipramine but only 0.1% of those on all tricyclic antidepressants analysed together. It was not reported in any of the 1,139 patients given duloxetine (a combined serotonin and noradrenaline reuptake inhibitor). It was reported in 0.025% of patients on selective serotonin reuptake inhibitors. UR was also reported inpatients on typical antispychotics, selective noradrenaline reuptake inhibitors but the studies did not define UR. The majority of case reports reported an improvement in UR on discontinuation or dose reduction.

Conclusion: Antipsychotics and antidepressants interact with the urinary system in many ways. Clinicians treating acute UR need to keep in mind the role of antipsychotic and antidepressants as a precipitating cause.