Veränderungen des Blasen- und Blasensphinktertonus durch Thymoleptika

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Abstract
During treatment with thymoleptics (amitriptyline, desipramine, dibenzepine, imipramine, nortriptyline) all of the 16 patients in whom the sphincter tonus of the urinary bladder was measured showed an increase, which was highly significant statistically in 10 cases. In 12 out of 31 depressed female patients, the amount of fluid required to fill the bladder sufficiently to provoke detrusor contractions at cystomanometric examination was markedly greater during, than before treatment with thymoleptics. Pressure within the bladder was mostly somewhat lowered, though in two cases a transient rise in intravesical pressure was observed. In 14 out of 15 cases the cholinergic effect of carbacholine (appearance of detrusor contractions and the desire to urinate) present before antidepressant treatment was abolished by the thymoleptics and greatly diminished in the remaining case. These findings, together with the previously confirmed local anaesthetic effect on the bladder mucosa and a central antidiuretic effect, explain the disturbances of water balance and micturition occurring under treatment with imipramine and related substances, as well as the favourable therapeutic results obtained in enuresis nocturna.

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