Double Incontinence as Adverse Effect During Brief Usage of Clonazepam

Abstract

Clonazepam, a benzodiazepine used for treating seizures, anxiety disorders, and movement disorders, is known for its central nervous system depressant side effects, such as drowsiness and urinary incontinence. However, double incontinence is rarely reported. We present the case of a 41-year-old woman with multilevel degenerative disc disease and right gastrocnemius-soleus muscle spasticity secondary to an Achilles tendon rupture, who developed who experienced dual incontinence after brief clonazepam use. Within three days of commencing clonazepam, she experienced nausea, fatigue, drowsiness, loose stools, and urinary frequency, progressing to urinary and faecal incontinence. Investigations, including blood tests, urine analysis, and abdominal imaging, were unremarkable, ruling out differential diagnoses such as infections, spinal pathology, and metabolic disorders. The patient responded positively to the antidote and supportive medical care, with total symptom relief two days after cessation of the medication. We discussed the causes of double incontinence, potential drug-induced incontinence, and the possible mechanisms by which clonazepam could cause double incontinence, given the limited evidence on it. Clonazepam’s sedative effects can lead to decreased muscle tone and coordination, potentially resulting in incontinence. Additionally, its impact on GABAergic pathways and anticholinergic effects could influence bladder and bowel function indirectly, but this is just a theory, and actual evidence is difficult to find. underscores the need for clinicians to recognize double incontinence as a potential adverse effect of clonazepam, even with short-term use, and to consider dose adjustments or alternative therapies when indicated. Further research into the mechanisms of clonazepam-induced double incontinence is warranted given the limited existing evidence.