CLOZAPINE AND URINARY-INCONTINENCE

Urinary incontinence may occur in patients with severe mental illness. Psychosis and neuroleptic medication have both been implicated, but t here has been a lack of systematic evaluation of the precise relations hip between these phenomena. Incontinence has been recognized as a com plication of clozapine treatment and we examined this in 16 consecutiv ely treated patients. Thirteen were established on therapeutic doses, one of whom was excluded from further study due to pre-existing incont inence. Retrospective assessment revealed that nocturnal incontinence was experienced by five of the remaining 12 patients, occurring in the first 3 months of treatment and resolving spontaneously in all cases. Incontinence was documented in the case notes in only one of the five cases and there was a tendency for affected patients to be embarrasse d and reluctant to report it to staff. Specific enquiry may be necessa ry to elicit this phenomenon and incontinence should be considered as a possible factor in poor compliance with clozapine.