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Selective serotonin reuptake
inhibitor-induced urinary incontinence.
Leufkens HG, Belitser SV, Lenderink AW, Egberts AC.
Pharmacy Midden-Brabant, TweeSteden Hospital, St. Elisabeth Hospital,
Tilburg, The Netherlands. firstname.lastname@example.org
Irrespective of its cause, urinary incontinence is a medical condition
seriously affecting quality of life and is increasingly recognized. In
this study, we examined the association between the use of selective
serotonin reuptake inhibitors (SSRIs) and urinary incontinence. METHODS:
A retrospective follow-up study among starters with an SSRI was
performed to estimate the relative and absolute risk for urinary
incontinence associated with SSRI use. Data came from the PHARMO
database, which includes information on drug dispensing for
approximately 450,000 residents living in eight Dutch cities. All
patients initially using an SSRI between 1994 and 1998 were selected.
The frequency measures for urinary incontinence were estimated by using
prescription sequence analysis, where initiation of spasmolytic drugs or
absorbent products was used as a measure for urinary incontinence.
Besides crude incidence density calculations, Andersen-Gill's model was
used in order to control for possible confounding factors and time
varying covariates. RESULTS: A total of 13,531 were identified as first
time users of an SSRI. Compared to non-exposure, the incidence density
ratio for urinary incontinence during SSRI exposure was 1.75 (95% CI
1.56-1.97). Overall, compared to baseline, SSRI use caused 14 extra
cases of urinary incontinence per 1000 patients treated per year; the
elderly were more at risk resulting in 60 extra cases per 1000 patients
per year. The adjusted relative risk for urinary incontinence due to
SSRI use was 1.61 (95% CI 1.42-1.82); the risk for sertraline users was
2.76; 95% CI 1.47-5.21). CONCLUSIONS: Exposure to SSRIs is associated
with an increased risk for developing urinary incontinence, which can be
explained pharmacologically. Approximately 15 out of 1000 patients
treated per year with an SSRI developed urinary incontinence. The
elderly and users of sertraline are at the highest risk.
12138594 [PubMed - indexed for MEDLINE]