Antipsychotic and Urinary retention

[sujalneuro]

Hi all, got a patient who holds diagnosis of Schizophrenia on Haldol 5 mg BID with Cogentin 1 mg BID, Zyprexa 15 mg BID. He came in because of AMS and urinary retention. I discontinued the Haldol and Cogentin thinking that it might be worsening urinary issues. Also don't see indication to be on 2 antipsychotics. What about Zyprexa change/keep? Any thoughts. Thanks!

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[lyla]

If this is an inpatient setting, I'd see how he does over the next few days. Olanzapine 30 mg/day is pretty much maxed out. Though olanzapine is more anticholinergic than Haldol so hard to say whether the urinary retention was from haldol/cogentin or olanzapine.