Q. I am wondering if my daughter is supersensitive to the side effects of pharmaceuticals, as I am. One of the documented side effects of Zoloft/sertraline is urinary incontinence and bladder problems. My daughter is no longer on the drug, but she still suffers these side effects four years after stopping it.
We have tried everything we can find to help her: naturopath, allopathic, chiropractic, homeopathic, and every imaging imaginable. Recently, she was prescribed antibiotics, which only exacerbated the problems.
How can we reverse the damage? She just turned 21, and she is miserable. It’s no way to live in the teen years.
A. You are correct that SSRI antidepressants can cause urinary incontinence in about 1.5% of patients (Pharmacoepidemiology and Drug Safety, June 2002). Sertraline is more likely than other such drugs to cause this problem.
Most doctors expect this problem to resolve after the drug is discontinued, but it seems that is not the case for your daughter. Unfortunately, there is very little research on treatments for a situation like hers. Physical therapy (pelvic floor muscle training) may be helpful and would be worth a try (Research and Reports in Urology, June 17, 2023).
Some experts in treating incontinence use lasers, devices called neuromodulators or functional magnetic stimulation, but we do not know if any of those approaches would be helpful. We are so sorry that she has had to live with these very distressing symptoms.
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Q. I occasionally take 0.25 milligrams of Xanax for sleep. I have not noticed any side effects, but I read that it could cause falls. Would this low dose make me fall?
A. It is good that you are using alprazolam (Xanax) only occasionally. It rapidly loses effectiveness if it is taken every night (Journal of Clinical Pharmacology, July 1987). In addition, some people can become habituated to it fairly quickly. As a result, it would not be our first choice of treatment. We suspect that even a low dose like yours might make you less steady if you get up during the night.
There are many other approaches to overcoming insomnia, and we discuss them in our “eGuide to Getting a Good Night’s Sleep.” You can find this online resource under the Health eGuides tab at www.PeoplesPharmacy.com.