Urinary retention can present as lessening of urinary output, bladder sensations, abnormal urinary flow, straining to void, and discomfort or pain. There are many potential causes of urinary retention. These include neurological conditions, diabetes, prostatitis, prostatic hypertrophy, medications, and obstructions. These should be considered. Medications with anticholinergic activity can cause urinary retention, dry mouth, blurred vision, or constipation. Anticholinergic activity impairs bladder contraction and emptying, particularly in males. Anticholinergic side effects are rare with most antidepressant medications. They are more common in older patients. Anticholinergic side effects have been reported with older tricyclic medications, paroxetine, mirtazapine, venlafaxine, reboxetine, and duloxetine. Anticholinergic potential often increases with increasing dose. Urinary retention can be urgent or emergent. If urinary retention is suspected, the patient should be promptly evaluated and treated.