A 2-year prospective follow-up study of lower urinary tract symptoms in patients treated with clozapine.
Urinary incontinence and enuresis are well-known side effects of clozapine. However, clinical experience has shown that patients also suffer from diverse lower urinary tract symptoms (LUTS). The natural course of clozapine-related LUTS is unclear. Thus, a longitudinal follow-up study is needed. A total of 101 subjects who were taking clozapine initially participated. Their LUTS were evaluated using the International Prostate Symptom Score (IPSS), other questionnaires, and a medical records review. After 2 years, 87 of the original subjects could be contacted, and the status of their LUTS was re-evaluated. The average IPSS total was 7.4 +/- 5.9 at the initial evaluation. Although only 11 subjects (10.9%) reported actual incontinence, 42 subjects (41.6%) were found to have clinically significant LUTS (IPSS total score > or =8). No influencing factors could be found among the demographic and clinical variables. At the follow-up, the average IPSS total (7.9 +/- 6.0) and the percentage of subjects with clinically significant LUTS (43.7%) had both increased, although the change was not statistically significant. The prevalence of LUTS in clozapine-medicated patients was higher than in the general population of the same age. However, the prevalence of incontinence was only a quarter of that of LUTS. If clinicians focus only on incontinence, distress from LUTS will not receive appropriate attention. Furthermore, contrary to literature observations, clozapine-related LUTS did not remit easily but rather persisted even into the long-term maintenance phase. More concern should be directed at these troublesome and often neglected side effects.
Jeong
Seong Hoon
SH
Department of Psychiatry, Dongguk University College of Medicine, Gyeonggi, South Korea.
Kim
Jong Hoon
JH
Ahn
Yong Min
YM
Lee
Kyu Young
KY
Kim
Soo-Woong
SW
Jung
Dong Chung
DC
Kim
Yong Sik
YS
D000328:Adult; D014150:Antipsychotic Agents / Q000009:adverse effects*; D003024:Clozapine / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008499:Medical Records; D011446:Prospective Studies; D011788:Quality of Life; D013315:Stress, Psychological; D011795:Surveys and Questionnaires; D013997:Time Factors; D014549:Urinary Incontinence / Q000139:chemically induced* / Q000523:psychology / Q000628:therapy; D014555:Urination Disorders / Q000139:chemically induced* / Q000523:psychology / Q000628:therapy; D055815:Young Adult
D014150:Antipsychotic Agents; D003024:Clozapine