Orsel Kim, Taipale Heidi, Raatikainen Sami, Lampela Pasi, Tolppanen Anna-Maija, Koponen Marjaana, Tanskanen Antti, Tiihonen Jari, Gardarsdottir Helga, Hartikainen Sirpa
Department of Urology, Kuopio University Hospital.
School of Pharmacy and.
J Clin Psychopharmacol. 2018 Oct;38(5):494-497. doi: 10.1097/JCP.0000000000000928.
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).
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.
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.
Use of APs did not increase the risk of initiating medication for BPH in men with AD.
已知抗精神病药物（APs）会加重良性前列腺增生（BPH）的症状，甚至可能导致尿潴留。APs的抗胆碱能作用及其对多巴胺D2和α受体的阻断作用可能导致BPH患者出现排尿功能障碍。我们研究的目的是调查在患有阿尔茨海默病（AD）的男性中，使用APs是否与开始使用治疗BPH药物的风险增加有关。
利用来自全国性的MEDALZ（药物使用与阿尔茨海默病）队列的数据，该队列包括芬兰所有被诊断患有AD的社区居住者。基于登记的数据包括药物配药、合并症和医院出院诊断。根据AD诊断后的时间和年龄，将开始使用APs的男性（n = 4579）与未开始使用APs的男性（n = 4579）进行1:1匹配。使用Cox回归研究开始使用BPH药物的风险。
在使用APs的患者中，有345人（7.5%）开始使用BPH药物。与未使用APs相比，使用抗精神病药物与开始使用BPH药物的风险无关（合并症调整后的风险比为0.92；95%置信区间为0.74 - 1.15）。此外，单独分析AP药物时未发现风险。
在患有AD的男性中，使用APs不会增加开始使用BPH药物的风险。
