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

  • Pharmacoepidemiology and Prescription
  • Published:
European Journal of Clinical Pharmacology Aims and scope Submit manuscript

Abstract

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.

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Acknowledgements

The authors thank Raymond C. Rosen, Mary P. Fitzgerald, Deborah C. Brander, and Gavin S. Miyasato for contributions to this manuscript.

Conflict of interest statement

Dr. William Steers reports service to the American Urologic Association as the editor of the Journal of Urology and is a consultant to New England Research Institutes. All other authors declare no conflicts of interest

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Authors and Affiliations

  1. New England Research Institutes, 9 Galen St., Watertown, MA, 02472, USA

    Susan A. Hall, Nancy N. Maserejian, Carol L. Link & John B. McKinlay

  2. University of Virginia School of Medicine, Charlottesville, VA, 22908, USA

    William D. Steers

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  1. Susan A. Hall
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  2. Nancy N. Maserejian
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  3. Carol L. Link
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Correspondence to Susan A. Hall.

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Hall, S.A., Maserejian, N.N., Link, C.L. et al. Are commonly used psychoactive medications associated with lower urinary tract symptoms?. Eur J Clin Pharmacol 68, 783–791 (2012). https://doi.org/10.1007/s00228-011-1170-9

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  • DOI: https://doi.org/10.1007/s00228-011-1170-9

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