A 60 yrs old male comes to casualty with acute retention of urine since 12 hrs. On examination there was distended bladder. His wife gives a history of taking some drug by the patient since 2 days as he is suffering from depression. The most likely drug is:
Anticholinergic effects of tricyclic antidepressants (TCAs) are most common. These effects result in dry mouth, constipation, urinary retention, blurred vision, and confusion. They are more common with teiary amine TCAs such as amitriptyline and imipramine than with the secondary amine TCAs desipramine and noriptyline. The potent alpha blocking propey of TCAs often results in ohostatic hypotension. H1 antagonism by the TCAs is associated with weight gain and sedation. The TCAs are class 1A antiarrhythmic agents and are arrhythmogenic at higher doses. Sexual effects are common, paicularly with highly serotonergic TCAs such as clomipramine. The TCAs have a prominent discontinuation syndrome characterized by cholinergic rebound and flulike symptoms. Ref: DeBattista C. (2012). Chapter 30. Antidepressant Agents. In B.G. Katzung, S.B. Masters, A.J. Trevor (Eds), Basic & Clinical Pharmacology, 12e.
CPZ
Amitriptyline
Haloperidol
Pimozide