TY - JOUR
T1 - Antipsychotic Use and the Risk of Initiating Medication for Benign Prostate Hyperplasia in Persons With Alzheimer Disease
T2 - A Matched Cohort Study
AU - Orsel, Kim
AU - Taipale, Heidi
AU - Raatikainen, Sami
AU - Lampela, Pasi
AU - Tolppanen, Anna-Maija
AU - Koponen, Marjaana
AU - Tanskanen, Antti
AU - Tiihonen, Jari
AU - Gardarsdottir, Helga
AU - Hartikainen, Sirpa
PY - 2018/10
Y1 - 2018/10
N2 - BACKGROUND: Antipsychotics (APs) are known to exacerbate symptoms of benign prostate hyperplasia (BPH) and may even cause urinary retention. The anticholinergic effects of APs and their dopamine D2- and α-receptor blockade may lead to voiding dysfunction of BPH patients. The objective of our study was to investigate whether the use of APs is associated with an increased risk of initiating medication for BPH in men with Alzheimer disease (AD).METHODS: Data from the nationwide MEDALZ (MEDication use and ALZheimer's disease) cohort, including all community-dwelling persons diagnosed with AD in Finland, were utilized. Register-based data included medication dispensing, comorbidities, and hospital discharge diagnoses. Men who initiated APs (n = 4579) were 1:1 matched with men who did not initiate APs (n = 4579), according to time since AD diagnoses and age. The risk of starting BPH medication was investigated with Cox regression.RESULTS: Among AP users, BPH medication was initiated to 345 persons (7.5%). Antipsychotic use was not associated with risk of initiating BPH medication (comorbidity-adjusted hazard ratio, 0.92; 95% confidence interval, 0.74-1.15) compared with no use of APs. In addition, no risk was found when AP drug substances were analyzed separately.CONCLUSIONS: Use of APs did not increase the risk of initiating medication for BPH in men with AD.
AB - BACKGROUND: Antipsychotics (APs) are known to exacerbate symptoms of benign prostate hyperplasia (BPH) and may even cause urinary retention. The anticholinergic effects of APs and their dopamine D2- and α-receptor blockade may lead to voiding dysfunction of BPH patients. The objective of our study was to investigate whether the use of APs is associated with an increased risk of initiating medication for BPH in men with Alzheimer disease (AD).METHODS: Data from the nationwide MEDALZ (MEDication use and ALZheimer's disease) cohort, including all community-dwelling persons diagnosed with AD in Finland, were utilized. Register-based data included medication dispensing, comorbidities, and hospital discharge diagnoses. Men who initiated APs (n = 4579) were 1:1 matched with men who did not initiate APs (n = 4579), according to time since AD diagnoses and age. The risk of starting BPH medication was investigated with Cox regression.RESULTS: Among AP users, BPH medication was initiated to 345 persons (7.5%). Antipsychotic use was not associated with risk of initiating BPH medication (comorbidity-adjusted hazard ratio, 0.92; 95% confidence interval, 0.74-1.15) compared with no use of APs. In addition, no risk was found when AP drug substances were analyzed separately.CONCLUSIONS: Use of APs did not increase the risk of initiating medication for BPH in men with AD.
KW - Alzheimer disease
KW - antipsychotic
KW - benign prostate hyperplasia
KW - dementia
KW - pharmacoepidemiology
UR - https://www.ncbi.nlm.nih.gov/pubmed/30102630
U2 - 10.1097/JCP.0000000000000928
DO - 10.1097/JCP.0000000000000928
M3 - Article
C2 - 30102630
SN - 0271-0749
VL - 38
SP - 494
EP - 497
JO - Journal of Clinical Psychopharmacology
JF - Journal of Clinical Psychopharmacology
IS - 5
ER -