title: Are commonly used psychoactive medications associated with lower urinary tract symptoms?
abstract: OBJECTIVE
  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.
authors.affiliation: New England Research Institutes, 9 Galen St., Watertown, MA 02472, USA. shall@neriscience.com
authors.forename: Susan A
authors.initials: SA
authors.lastname: Hall
authors.forename: Nancy N
authors.initials: NN
authors.lastname: Maserejian
authors.forename: Carol L
authors.initials: CL
authors.lastname: Link
authors.forename: William D
authors.initials: WD
authors.lastname: Steers
authors.forename: John B
authors.initials: JB
authors.lastname: McKinlay
mesh_terms: D000328:Adult; D000368:Aged; D001900:Boston / Q000453:epidemiology; D015986:Confounding Factors, Epidemiologic; D003430:Cross-Sectional Studies; D003863:Depression / Q000150:complications / Q000188:drug therapy*; D004359:Drug Therapy, Combination / Q000009:adverse effects; D005260:Female; D006306:Health Surveys; D006801:Humans; D059411:Lower Urinary Tract Symptoms / Q000139:chemically induced / Q000150:complications / Q000453:epidemiology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D015995:Prevalence; D011619:Psychotropic Drugs / Q000009:adverse effects* / Q000627:therapeutic use; D012307:Risk Factors; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects / Q000627:therapeutic use; D012720:Severity of Illness Index; D012727:Sex Characteristics
chemical_list: D011619:Psychotropic Drugs; D017367:Selective Serotonin Reuptake Inhibitors