Are commonly used psychoactive medications associated with lower urinary tract symptoms?

• Published in: European journal of clinical pharmacology 2012-05, Vol.68 (5), p.783-791
• Main Authors: Hall, Susan A., Maserejian, Nancy N., Link, Carol L., Steers, William D., McKinlay, John B.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Biological and medical sciences; Biomedical and Life Sciences; Biomedicine; Boston - epidemiology; Confounding Factors (Epidemiology); Cross-Sectional Studies; Depression - complications; Depression - drug therapy; Drug Therapy, Combination - adverse effects; Epidemiology; Female; Health Surveys; Humans; Lower Urinary Tract Symptoms - chemically induced; Lower Urinary Tract Symptoms - complications; Lower Urinary Tract Symptoms - epidemiology; Lower Urinary Tract Symptoms - physiopathology; Male; Medical sciences; Middle Aged; Models, Biological; Nephrology. Urinary tract diseases; Pharmacoepidemiology and Prescription; Pharmacology. Drug treatments; Pharmacology/Toxicology; Prevalence; Psychopharmacology; Psychotropic Drugs - adverse effects; Psychotropic Drugs - therapeutic use; Risk Factors; Serotonin Uptake Inhibitors - adverse effects; Serotonin Uptake Inhibitors - therapeutic use; Severity of Illness Index; Sex Characteristics; Urinary system involvement in other diseases. Miscellaneous; Urinary tract diseases; Urinary tract. Prostate gland
• ISSN: 0031-6970; 1432-1041
• DOI: 10.1007/s00228-011-1170-9

Purpose Lower urinary tract symptoms (LUTS) such as urinary frequency and urgency are bothersome and associated with reduced quality of life. Atypical antipsychotics (AAPs) have been implicated in increasing the risk of urinary incontinence. In a large community-based sample of men and women, we examined the associations of AAP and selective serotonin reuptake inhibitor (SSRIs) use with LUTS. Methods Data were collected (2002–2005) from a generalizable sample of Boston, MA, USA, residents aged 30–79 ( N  = 5503). LUTS were assessed using the American Urologic Association Symptom Index (AUA-SI). The prevalence of clinically-significant LUTS was estimated using a cutoff AUA-SI score of 8+ to indicate moderate-to-severe symptoms. Confounder-adjusted odds ratios (ORs) and 95% confidence intervals (CI) were calculated from multivariate logistic regression to estimate the associations for psychoactive drugs used in the previous month (SSRIs, AAPs, both) and LUTS. Results Among women, AAP users had a higher prevalence of LUTS (46.2%) compared with SSRI users (23.5%) and those with depressive symptoms not using SSRIs or AAPs (26.3%). Corresponding prevalence estimates among men were 32.7%, 29.8%, and 33.3%. In multivariate models, AAP use was significantly associated with LUTS among women when used either with (OR = 2.72, 95% CI:1.45–5.10) or without (OR = 3.05, 95% CI:1.30–7.16) SSRIs, but SSRI use without AAP use was not associated with LUTS compared with nonusers without depressive symptoms. No associations were observed among men. Conclusions In our study, AAPs but not SSRIs were associated with increased prevalence of LUTS among women only. Further prospective research is needed to determine time sequence and cause and effect.