next »

[flamglam]

Increased urination can be an eariy sign of prostate cancer. I'd get a PSA test ASAP. Luckily, it is easily treatable and not aggressive, so even if  you do have this, it should be handled in short order. Good luck!

[mountainguy]

If you're actually producing a good volume of urine each time, diabetes should be the first thing your doc looks at. Otherwise, my guess is infection. The docs have gotten ridiculous about withholding antibiotics but I'd go push for that and see if it does the trick. Much better than messing with your head.

Increased urination can be an eariy sign of prostate cancer. I'd get a PSA test ASAP. Luckily, it is easily treatable and not aggressive, so even if  you do have this, it should be handled in short order. Good luck!

Thanks to both of you for the ideas, but my blood sugar and prostate levels in the blood work last week were both within normal range. I'm pretty sure the Lexapro is the culprit. My plan now is to keep a log of my fluid intake and trips to the bathroom, so that I have specific evidence to cite to the psychiatrist during my next appointment.

[msparticularity]

If you're actually producing a good volume of urine each time, diabetes should be the first thing your doc looks at. Otherwise, my guess is infection. The docs have gotten ridiculous about withholding antibiotics but I'd go push for that and see if it does the trick. Much better than messing with your head.

Increased urination can be an eariy sign of prostate cancer. I'd get a PSA test ASAP. Luckily, it is easily treatable and not aggressive, so even if  you do have this, it should be handled in short order. Good luck!

Thanks to both of you for the ideas, but my blood sugar and prostate levels in the blood work last week were both within normal range. I'm pretty sure the Lexapro is the culprit. My plan now is to keep a log of my fluid intake and trips to the bathroom, so that I have specific evidence to cite to the psychiatrist during my next appointment.

Even that's not necessarily evidence, since there is so much individual variability in these things--peoples' bladder capacity and sensitivity to fullness are very different. What is more striking, to me, is the exact correlation between the problem and the medication, combined with the elimination of the other explanations. There just are doctors who seem to think that if they admit their precious meds might have some side effects that this will cause us to develop them psychosomatically. IMO, the more appropriate response would be for the doctor in question to discuss the meds and the trade-offs involved, which allows the patient to actually make an informed decision rather than trusting blindly. Blind trust is what a lot of these guys want, though--there have been a lot of studies identifying the whole "God complex" that many medical specialties seem to be prone to.

[mountainguy]

MsP: yes, absolutely! I figure that going in to the appointment with evidence that I'm having a problem is better than simply telling the psychiatrist that I think she's wrong about the lack of side effects.

It's also worth noting that the psychiatrist is affiliated with the university health center. It was easier and cheaper to get into their system than it was to get a referral through my health insurance, but I'm beginning to sense a quality tradeoff. The staff at the health center appears overworked to me, and the psychiatrist is very young (she's probably in her mid-30s). I still want to try meeting with her again, but if things aren't satisfactorily resolved, it's probably going to be time for me to work on getting my health insurance to approve a referral to someone in private practice.

[msparticularity]

More thoughts on the biology behind the situation: part of what happens during deep sleep cycles is that the kidneys concentrate urine more. When the sleep cycle is altered, it can upset that chemistry so the kidneys don't concentrate more and just keep processing at their normal daytime rate. There is speculation/evidence that many kinds of meds can upset the sleep cycle and endocrine function, and it wouldn't be surprising to me if many of the SSRIs have that effect. So, why your psych would think that it is unlikely the med is causing this is truly beyond me. It is also the case that Lexapro is one of the meds that is getting very heavy marketing and "physician education" imparted by the drug reps. Here again, we see a lot of influencing of practitioner thinking by Big Pharma.

[glowdart]

You've got a roommate who's sticking your hand in a glass of water in the middle of the night, don't you?



Seriously, if the usual culprits (diabetes, prostrate) are not showing up as possibilities in your bloodwork and there's any correlation between the urination and the introduction of the medication to your life, then all signs seem to point to the medication. 

I would be more insistent with your doc, but I would suggest talking to the pharmacist to get some more ammo for your chat with your doc.  (I have always found pharmacists to be much more informed about potential side effects and interactions; I'm one of those people who gets the weird side effects to meds or has no side effect, but never has the common ones.)

[msparticularity]

I would be more insistent with your doc, but I would suggest talking to the pharmacist to get some more ammo for your chat with your doc.  (I have always found pharmacists to be much more informed about potential side effects and interactions; I'm one of those people who gets the weird side effects to meds or has no side effect, but never has the common ones.)

This has been my experience, too. When the rheumatologist I saw last fall put me on Relafin for my bursitis and I began developing massive rashes, he refused to believe there was any connection. Some time later, in a casual chat with my pharmacist late one evening when he wasn't busy, I said something to him about it. He said something along the lines of, "Oh, yeah, I think that's pretty common," then got on his computer and looked it up. It was 15%--15 friggin' percent, and the idiot doctor sneered at me.

I have a new doctor now. 

[tee_bee]

Two ideas:

1. I was on something (It wasn't wellbutrin, I don't think) for a week (anxiety following bad vertigo spell, due to ear injury from flying with a bad cold). OMG, others loved my drug, but I was way over agitated, and peeing all the time, all night long. Drank three gallons of red gatorade, peed 10 gallons (it seemed) of red gatorade, which was a freakout. Drinking due to dehydration, I think because of the drug. My lesson was that the meds really made me pee, which forced me to drink more liquids, which....

2. A very random thought, and what I've heard wouldn't suggest this, but in the past three years I had to get up once a night to urinate. I was diagnosed with sleep apnea some months ago, got the CPAP, and have not yet had to get up in the night to pee. And sleep like a baby too. If you have sleep apnea, this can really trigger the urge to void.

Of course, the biggest risk factor for obstructive sleep apnea are overweight, and the major symptoms are massive daytime sleepiness. If you are neither category, this is off the list.

I hope you get this squared away--it can be really annoying.

[lolar2]

Thin people can have sleep apnea, but if you aren't sleepy during the day (as in, you couldn't fall asleep during the world's most boring lecture with the lights low no matter how hard you try), yes, it's out of the running.

[tee_bee]

Thin people can have sleep apnea, but if you aren't sleepy during the day (as in, you couldn't fall asleep during the world's most boring lecture with the lights low no matter how hard you try), yes, it's out of the running.

Good point. I am blessed (?) by what a classmate called a "robust physique," which has led to the apnea. Others may not be so disposed, but if you're sleepy in the day time, and getting up to urinate at night, that's a possibility. I think it's probably a distant one in this case. OP, let us know what happens?

[frogfactory]

Thanks to both of you for the ideas, but my blood sugar and prostate levels in the blood work last week were both within normal range.

M_G - I don't want to worry you, but you cannot rule out (or confirm) diabetes with a single blood test.  You really should have a glucose tolerance test.  It's cheap and simple and your doctor should already have suggested it to you.  How likely it is I couldn't comment on, but diabetes is common and serious enough that you really ought to know for sure.

[grantsmaven]

If you are not urinating large amounts but consistently feel the urge to urinate, it sounds like you could be suffering from pelvic floor dysfunction.  I'm not a medical professional but have suffered from the chronic feeling of needing to urinate (although I don't really have to) since I was 12 (I'm currently in my late twenties).  In my case, interstitial cystitis is the primary cause but pelvic floor dysfunction (PFD) increases the urge substantially.  Basically PFD is a syndrome of overly tight muscles, ligaments and fascia in the pelvic floor, often with painful trigger points.  Its trademark is UTI symptoms that do not respond completely to medication.  PFD can be caused by a myriad of things, including a fall on your backside/tailbone, chronic constipation, a UTI, etc.  Some people might tell you PFD mostly causes constipation, not frequent urination; however, for a number of men and women, a frequent and/or persistent need to urinate is the primary complaint.

If the medication proves not to be the cause, I'd look into having a full work-up by a urologist for interstitial cystitis (including a look into your bladder with a a small camera) and an evaluation by a physical therapist who specializes in pelvic floor dysfunction (often he or she will work with pelvic pain patients).  Try to avoid PTs who work exclusively with women who have pelvic organ prolapses and/or incontinence as they will tell you to do kegels or other exercises to "build-up" the muscles by repeated contractions.... this isn't helpful at all for people with an overly tight pelvic floor.  Look for a PT who uses myofascial release and inter-rectal and/or inter-vaginal manual therapy.  Sounds embarrassing I know but can really help people with PFD.  Valium or Flexeril can be helpful too.

The medication could def. be the cause, but I just wanted to mention something of which many people (including doctors!) may be unaware.

[mountainguy]

Just a quick update to say that my condition has become somewhat more manageable. I''m only getting up two times during the night instead of three or four, and usually falling back to sleep right away. My counselor has advised me to keep a written record of what's going on so that I can have ample evidence the next time I talk to the psychiatrist about the issue.

[oldfullprof]

It's the Lexapro, people.  At least it needs to be ruled out first.  The symptoms emerged after the med was started.