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Article
June 14, 1976

Urinary Retention as a Complication of Levodopa Therapy

Author Affiliations

New Jersey College of Medicine Hackensack

JAMA. 1976;235(24):2586. doi:10.1001/jama.1976.03260500014014

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Abstract

To the Editor.—  Urinary retention is an occasional troublesome side effect of levodopa therapy. For example, it developed in a 49-year-old man with moderate bilateral parkinsonism who was taking levodopa. Substitution of a mixture of carbidopa and levodopa (Sinemet) did not alleviate this symptom. Cystoscopy did not disclose significant prostatic obstruction, but a cystometric examination did disclose a hypotonic bladder. The addition of phenoxybenzamine hydrochloride (Dibenzyline), 10 mg three times a day, completely reversed the urinary retention without exacerbating the parkinsonism.These observations suggest that the levodopa effect on the bladder is, at least in part, central (ie, inside the blood-brain barrier), since carbidopa (100 mg/day) did not block this effect. Furthermore, phenoxybenzamine may be useful clinically in reversing levodopa-induced urinary retention, without exacerbating the parkinsonism.From pharmacological considerations, one might have anticipated an increase in postural hypotension and compensatory tachycardia with this combination. Fortunately, this did not occur to

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