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Antipsychotic Use and the Risk of Initiating Medication for Benign Prostate Hyperplasia in Persons With Alzheimer Disease

A Matched Cohort Study

Orsel, Kim BSc*†; Taipale, Heidi PhD†‡§; Raatikainen, Sami PhD, MD; Lampela, Pasi PhD, MD†‡; Tolppanen, Anna-Maija PhD; Koponen, Marjaana PhD†‡; Tanskanen, Antti PhilLic§¶; Tiihonen, Jari PhD, MD§¶; Gardarsdottir, Helga PhD*; Hartikainen, Sirpa PhD, MD†‡

Journal of Clinical Psychopharmacology: October 2018 - Volume 38 - Issue 5 - p 494–497
doi: 10.1097/JCP.0000000000000928
Brief Reports

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.

From the *School of Pharmacy, Utrecht University, Utrecht, the Netherlands;

School of Pharmacy and

Kuopio Research Centre of Geriatric Care, University of Eastern Finland, Kuopio, Finland;

§Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden; and

Department of Urology, Kuopio University Hospital; and

Department of Forensic Psychiatry, Niuvanniemi Hospital, University of Eastern Finland, Kuopio, Finland.

Received January 9, 2018; accepted after revision June 27, 2018.

Reprints: Heidi Taipale, PhD, Kuopio Research Centre of Geriatric Care, University of Eastern Finland, PO Box 1627, 70211 Kuopio, Finland (e-mail:

No funding was received for this study.

Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.