Contribution of Common Medications to Lower Urinary Tract Symptoms in Men

Wuerstle, Melanie; Eeden, Stephen K. Van Den; Poon, Kwun-Yee T.; Quinn, Virginia P.; Hollingsworth, John M.; Loo, Ronald K.; Jacobsen, Steven J.

doi:10.1001/archinternmed.2011.475

Cited by 31 publications

(16 citation statements)

References 7 publications

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“…al found a significant association of antidepressant use with LUTS among men aged 45 to 69 years (OR=1.36, 1.29–1.44). [13] This result (adjusted for BPH status) was similar in magnitude to our adjusted findings for men for SSRIs in Table 2, but was not further adjusted for comorbidities such as depressive symptoms and diabetes which may explain the differences compared to our results. When minimally adjusted for age and race/ethnicity, our association for use of SSRIs without AAPs among men was also statistically significant (OR=1.98, 95% CI: 1.36–2.87, data not shown).…”

Section: Discussionsupporting

confidence: 80%

“…[12] There is also evidence that selective serotonin reuptake inhibitor (SSRI) antidepressants could increase the risk of LUTS. [13] Prior associations between SSRIs and nocturia and risk of urinary incontinence have been documented. [14, 15] Possible pathways include promotion of cholinergic neuromuscular transmission in the detrusor muscle, as well as influence on autonomic function.…”

Section: Introductionmentioning

confidence: 99%

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

Hall

Maserejian

Link

et al. 2011

Eur J Clin Pharmacol

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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 use 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 to 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 SSRIs (OR=2.72, 95%CI:1.45–5.10), or without SSRIs (OR=3.05, 95%CI:1.30–7.16) but SSRI use without AAP use was not associated with LUTS, compared to non-users 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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Section: Discussionsupporting

confidence: 80%

Section: Introductionmentioning

confidence: 99%

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

Hall

Maserejian

Link

et al. 2011

Eur J Clin Pharmacol

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“…The presence of one or more prescription claims for calcium channel blockers (diltiazem or verapamil), sedative hypnotics and anxiolytics, antimuscarinic medications used to treat OAB, anticholinergics (Appendix 1), alpha antagonists, antipsychotics, AChEIs, or digoxin was determined. [18][19][20][21][22][23][24][25][26][27][28][29][30][31][32] With the exception of antimuscarinics, these medications have been associated with potentially reversible UI or will contribute to a pharmacodynamic drug-drug interaction or a pharmacodynamic drug-disease interaction in individuals when administered concomitantly. Calcium channel blockers have been associated with bladder sphincter relaxation and impaired emptying, and AChEIs can precipitate urgency incontinence through cholinergic activity in the bladder.…”

Section: Total Number Of Residents With Oab And/or Ui Who Had Mds Andmentioning

confidence: 99%

Challenges in the Pharmacological Management of Nursing Home Residents with Overactive Bladder or Urinary Incontinence

Zarowitz¹,

Allen²,

O’Shea³

et al. 2015

J American Geriatrics Society

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“…Prior associations between the use of SSRIs and nocturia and the risk of UI have been reported [10,11]. SSRI antidepressants might increase the risk of lower urinary tract symptoms [18], as related pathways are likely to increase cholinergic neuromuscular transmission in the detrusor muscle and disrupt autonomic function [19,20]. Some research shows that the inhibition of 5-hydroxytryptamine (5-HT) and norepinephrine reuptake plays a crucial role in the regulation of lower urinary tract function [21].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Overactive Bladder in Male Antidepressant Users: A Prospective Study

Solmaz¹,

Albayrak²,

Tekatas³

et al. 2017

Int Neurourol J

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PurposeIn this study, we investigated overactive bladder (OAB) functions in male patients who used antidepressant drugs (ADs) that were previously examined in female patients, based on conflicting data in literature regarding the effects of AD on OAB and the differences between male and female urinary system physiologies (anatomical and hormonal).MethodsThe study included 202 male patients (a control group of 90 healthy subjects, and an experimental group of 112 patients taking ADs for different disorders). All the patients completed the overactive bladder-validated 8 (OAB-V8) questionnaire, the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF), and the Beck Depression Inventory (BDS).ResultsThe OAB-V8, ICIQ-SF, and BDS scores for the antidepressant users were significantly higher than those of the control group. The highest prevalence of OAB symptoms was observed in patients taking venlafaxine (68.2%), and the lowest prevalence was in patients taking sertraline (28.0%). Moreover, the frequency of OAB between the antidepressant groups was statistically significant. The univariate logistic regression analyses showed a significant relationship between the presence of OAB, antidepressant usage, BDS score, and the age of a patient. In the multivariate logistic regression analyses, the association between the presence of OAB and antidepressant usage was statistically significant.ConclusionsThe present study showed that the incidence of OAB and the severity of OAB symptoms increased in males using antidepressants for various disorders. This may have been due to unique pharmacological effects, on a molecular or individual level, of serotonin-norepinephrine reuptake inhibitors.

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Contribution of Common Medications to Lower Urinary Tract Symptoms in Men

Cited by 31 publications

References 7 publications

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

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

Challenges in the Pharmacological Management of Nursing Home Residents with Overactive Bladder or Urinary Incontinence

Evaluation of Overactive Bladder in Male Antidepressant Users: A Prospective Study

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