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BackroundAnticholinergic drugs are the most commonly used addictive drugs among non-prescription drugs. Oxybutynin is one of the anticholinergic drugs widely used for overactive bladder and nocturnal enuresis treatment for both adults and children. Here is a new case of oxybutynin use with high dose and long-term use despite recurrent treatment applications. Case PresentationA 25 years old, unemployed man that was graduated from primary school applied to the inpatient clinic. He reported that he has been using oxybutynin for 8 years. He was taking 500 mg/day of oxybutynin (100 pills in a day), approximately. He stated that he had taken 250-300 pills in some days (1000-1500 mg/day). He described agitation, irritability, anxiety, visual and auditory hallucinations, reference thoughts, and persecution delusions. The patient was diagnosed with Other Substance Use Disorders according to the Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5) criteria. Carbamazepine 400 mg/day, olanzapine 10 mg/day, and lorazepam 2.5 mg/day treatments were started. At the end of the five weeks, both symptoms improved completely. In the follow-up, he had no psychiatric symptoms two months after the discharge. He was not using any substance or addictive drugs; working regularly in his father’s family business. ConclusionsOxybutynin is one of the non-controlled drugs, so can be obtained easily from pharmacies without a prescription in Turkey. Interestingly, case reports about oxybutynin use are all from Turkey. Oxybutynin should be considered for the potential for addiction due to its anticholinergic properties, easily accessible, and cumulative cases. Psychiatrists and non-psychiatric physicians, especially urologists should be aware of the addiction potential of the drug because of anticholinergic effects, especially between substance users, and oxybutynin may cause some psychotic effects. |
