Hello doctor,I am a 41-year-old female, 143 lbs. I currently take Lisdexamfetamine 50 mg for ADHD. I have been experiencing bladder discomfort off and on for three months now. It was quite intense for two weeks, then went away for several weeks, and now is present again although less intense. It just feels like I have a tight bladder all the time and need to use the toilet more often. There is no pain or difficulty when urinating. I have had two negative UTI tests and a normal ultrasound. I have had a completely normal cervical exam as well. I have been taking Dexamfetamine since last six months, and the symptoms arose two months later. I am wondering if the medication is causing bladder irritation, or tightening, or if the medication is turning my urine more acidic and that is the problem? It has been suggested that I use an alkalizing agent, but that seems to be contraindicated with the Lisdexamfetamine. I also have learned that Amphetamine products can liberate Histamine, and that might cause bladder irritation? Can you advise what might be the issue if the medication is contributing and how I might best address it? I do not have a better option for ADHD treatment and would like to deal with this symptom rather than change my medication.
Hi. If you are having increased frequency of urination, night-time frequency, the urgency of urination, it may be an overactive bladder. It can occur spontaneously or be precipitated by UTI episodes, stone disease, medications, etc. In your case, the medicine may not be responsible. But anyway, we cannot change the medicine. You need to restrict your fluid intake to about 2 to 2.5 liters per day, limit intake of carbonated beverages, coke, tea, coffee. You have to avoid constipation. You may also get a urine test done for sugar to rule out diabetes. If frequency persists, you may take an anticholinergic like Tolterodine or Darifenacin after consulting your doctor. Take care.