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One of the troublesome side-effects of tricyclic anti-depressants is urinary hesitancy due to their anticholinergic effects.1
Reboxetine, the only selective noradrenaline reuptake inhibitor, is an effective and well-tolerated antidepressant. Since it has low affinity for muscarinic, cholinergic receptors,2 anticholinergic side-effects such as urinary retention or hesitancy are not expected.
However, some patients on reboxetine (2–4 mg/day) complain of urinary hesitancy. A peripheral noradrenergic mechanism termed ‘pseudoanticholinergic syndrome’ may be responsible for this side-effect.3