Medication use and association with urinary incontinence in women: Data from the Norwegian Prescription Database and the HUNT study

Mauseth, Siri A.; Skovlund, Eva; Spigset, Olav

doi:10.1002/nau.23473

Cited by 5 publications

(9 citation statements)

References 25 publications

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“…The association between the use of psychotropics and UI has previously been investigated in the same data material from HUNT3, and the selection of drugs in our model were chosen partly based on the results in this study [ 16 ]. Mauseth et al found adjusted associations between use of SSRIs and UI and between use of lamotrigine and UI, with ORs 1.52 and 2.73, respectively, for two or more prescriptions during the last 6 months.…”

Section: Discussionmentioning

confidence: 99%

“…The following drug groups were used in the analyses: Opioid analgesics (ATC-code: N02A), other analgesics (N02B), antiepileptic drugs (N03), lamotrigine (N03A X09), antiparkinson drugs (N04), antipsychotics (N05A), anxiolytics (N05B), hypnotics and sedatives (N05c), antidepressants (N06A) and selective serotonine reuptake inhibitors (SSRIs) (N06AB), urologics (G04BD), estrogens (G03C) and progesterons and estrogens in combination (G03F). We selected drug groups due to literature indicating possible association with UI [ 13 – 16 , 26 – 28 ].…”

Section: Methodsmentioning

confidence: 99%

“…In all the logistic regression analyses, we adjusted for the following potential confounders and risk factors: age, BMI, parity, diabetes, asthma, myocardial infarction, cerebral stroke, chronic pain, rheumatoid arthritis, use of urologic medication for urgency, and use of estrogen replacement medication. The adjustment variables were chosen based on pre-specified known risk factors and medication with possible impact on UI prevalence [ 16 , 29 ].…”

Section: Methodsmentioning

confidence: 99%

“…Antidepressants affecting this neuro-hormonal system are the leading pharmacological intervention for mood- and anxiety disorders [ 9 – 11 ], but the antidepressant duloxetine has also documented effect as treatment for stress UI [ 12 , 13 ]. Beside being a treatment for UI, several studies have also shown an association between the use of antidepressants and high prevalence of UI, strongest for mixed and urgency UI [ 14 – 16 ]. It is unknown whether confounding by indication can explain this association, or whether antidepressants induce UI through biological mechanisms.…”

Section: Introductionmentioning

confidence: 99%

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Urinary incontinence associated with anxiety and depression: the impact of psychotropic drugs in a cross-sectional study from the Norwegian HUNT study

2020

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Background Anxiety and depression are in both cross-sectional and longitudinal studies associated with urinary incontinence (UI) in women, strongest for the urgency component of UI. The role of psychotropic drugs in this association, especially antidepressants, has been questioned, but not clarified. The present study aimed to explore the associations between UI and anxiety/depression and the possible impact of psychotropic drugs on these associations. Methods We conducted a cross-sectional, population-based study with questionnaire data from 21,803 women ≥20 years in the Norwegian Nord-Trøndelag Health Study merged with the Norwegian Prescription Database, which contains information on all dispensed prescriptions. We used multivariate logistic regression to investigate the association between UI (any UI, and by type and severity) and anxiety/depression (by different score on Hospital anxiety and depression scale), and the influence of psychotropic drugs on this association (by different volume of drug use). Results Compared with normal anxiety- and depression score, having moderate/severe anxiety or depression (HADS≥11) increased the prevalence of UI from 27.6 to 37.8% (OR 1.59 (1.40–1.81), p < 0.001) for anxiety and from 28.0 to 43.7% (OR 1.79 (1.46–2.21), p < 0.001) for depression. According to type of UI, mixed UI was most strongly associated with a high HADS-score with an odds ratio 1.84 (1.65–2.05) for anxiety and 1.85 (1.61–2.13) for depression. Compared to no UI, severe UI was associated with depression with odds ratios of 2.04 (1.74–2.40), compared with no UI. Psychotropic drug use did not influence the associations between UI and anxiety/depression. We found high prevalence of UI among users of various psychotropic drugs. After adjustments, only antidepressants were associated with UI, with OR 1.36 (1.08–1.71) for high defined daily dose of the drug. Anxiolytics were associated with less UI with OR 0.64 (0.45–0.91) after adjustments for anxiety. Conclusion This study showed that anxiety, depression and use of antidepressants are associated factors with UI, strongest for urgency and mixed type of UI, with increasing ORs by increasing severity of the conditions and increased daily dose of the medication. Use of antidepressants did not influence the associations between UI and anxiety/depression.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Urinary incontinence associated with anxiety and depression: the impact of psychotropic drugs in a cross-sectional study from the Norwegian HUNT study

2020

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“…The most problematic would be documentation of actual prescription filling, but this is a topic of increasing interest to the medical and academic communities and access to such information we hope will improve. [32][33][34]…”

Section: Limitationsmentioning

confidence: 99%

Preoperative Care Assessment of Need Scores Are Associated With Postoperative Mortality and Length of Stay in Veterans Undergoing Knee Replacement

Kuo¹,

Schroeder²,

Barbeito³

et al. 2021

Federal Practitioner

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Background: Care Assessment of Need (CAN) scores predicting 90-day mortality and hospitalization are automatically computed each week for patients receiving care at Veterans Health Administration facilities. While currently used only by primary care teams for care coordination, we explored their value as a perioperative risk stratification tool before major elective surgery. Methods: We collected relevant demographic and perioperative data along with perioperative CAN scores for veterans who underwent total knee replacement between July 2014 and December 2015. We examined score distribution, relationships of preoperative CAN 1-year mortality scores with 1-year postoperative mortality and index hospital length of stay (LOS), and patterns of mortality. Results: Among 8206 patients, 1-year mortality was 1.4% (110 patients), and CAN scores exhibited near-normal distribution.Median scores among survivors were significantly higher than those of in nonsurvivors (45 vs 75; P < .001). The Kaplan-Meier curves showed an approximately 4-fold higher rate of death at 1 year in the highest tercile for 1-year mortality CAN scores compared with those with lower scores (2.0% vs 0.5% respectively; P < .001). Locally estimated scatterplot smoothing curves revealed a significant and nonlinear increase in hospital LOS across preoperative CAN scores. Conclusions: Although designed for ambulatory care use, CAN scores can identify patients at high risk for mortality and extended hospital LOS in an elective surgery population. The CAN scores may prove valuable in supporting informed decision making and preoperative planning in high-risk and vulnerable populations. Further study is needed to confirm the validity of CAN scores and compare them to other more widely used surgical risk calculators.

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Effect of single doses of citalopram and reboxetine on urethral pressure: A randomized, double‐blind, placebo‐ and active‐controlled three‐period crossover study in healthy women

Christoffersen

Kornholt

Riis

et al. 2022

Neurourology and Urodynamics

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Aims: Urethral closure function is essential for urinary continence in women and decreased urethral pressure is associated with stress urinary incontinence (SUI). For decades, the effects of serotonergic drugs on central neural control of urethral closure have been investigated and discussed. Epidemiological studies suggest that the use of selective serotonin reuptake inhibitors (SSRIs), such as citalopram, is associated with SUI. However, the literature findings are conflicting. This study aimed to evaluate citalopram's effect on opening urethral pressure (OUP) in healthy women. Methods: We conducted a randomized, double-blind, placebo-and activecontrolled crossover study in 24 healthy women. On three study days, which were separated by 8 days of washout, the subjects received single doses of either 40 mg citalopram (and placebo reboxetine ), 8 mg reboxetine (and placebo citalopram ), or two placebos. Study drugs were administered at a 1-h interval due to a difference in estimated time to peak plasma concentration (t max ). We measured OUP with urethral pressure reflectometry under both resting and squeezing conditions of the pelvic floor at estimated t max for both study drugs (one timepoint).Results: Compared to placebo, citalopram increased OUP by 6.6 cmH 2 0 (95% confidence interval [CI] 0.04-13.1, p = 0.048) in resting condition. In squeezing condition, OUP increased by 7.1 cmH 2 0 (95% CI: 1.3-12.9, p = 0.01). Reboxetine increased OUP by 30.0 cmH 2 0 in resting condition compared to placebo (95% CI: 23.5-36.5, p < 0.001), and 27.0 cmH 2 0 (95% CI: 21.2-32.8, p < 0.001) in squeezing condition. Conclusion: Citalopram increased OUP slightly compared to placebo suggesting that SSRI treatment does not induce or aggravate SUI.

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Medication use and association with urinary incontinence in women: Data from the Norwegian Prescription Database and the HUNT study

Abstract: The odds for having UI were found to be about 1.5-fold in women using SSRIs and almost threefold in women using lamotrigine. The association with lamotrigine has not been reported previously, and should be further evaluated in future studies.

Cited by 5 publications

References 25 publications

Urinary incontinence associated with anxiety and depression: the impact of psychotropic drugs in a cross-sectional study from the Norwegian HUNT study

Urinary incontinence associated with anxiety and depression: the impact of psychotropic drugs in a cross-sectional study from the Norwegian HUNT study

Preoperative Care Assessment of Need Scores Are Associated With Postoperative Mortality and Length of Stay in Veterans Undergoing Knee Replacement

Effect of single doses of citalopram and reboxetine on urethral pressure: A randomized, double‐blind, placebo‐ and active‐controlled three‐period crossover study in healthy women

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