title: A 2-year prospective follow-up study of lower urinary tract symptoms in patients treated with clozapine.
abstract: 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.
authors.affiliation: Department of Psychiatry, Dongguk University College of Medicine, Gyeonggi, South Korea.
authors.forename: Seong Hoon
authors.initials: SH
authors.lastname: Jeong
authors.forename: Jong Hoon
authors.initials: JH
authors.lastname: Kim
authors.forename: Yong Min
authors.initials: YM
authors.lastname: Ahn
authors.forename: Kyu Young
authors.initials: KY
authors.lastname: Lee
authors.forename: Soo-Woong
authors.initials: SW
authors.lastname: Kim
authors.forename: Dong Chung
authors.initials: DC
authors.lastname: Jung
authors.forename: Yong Sik
authors.initials: YS
authors.lastname: Kim
mesh_terms: 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
chemical_list: D014150:Antipsychotic Agents; D003024:Clozapine