Antipsychotic treatment influence on urinary incontinence in young women-types, severity and life quality

Background and objectives: Urinary incontinence is a common disorder in women that significantly impacts daily life. Antipsychotic drugs are known to influence urinary incontinence. However, clear information is lacking regarding the prevalence, types and its impacts on the quality of life in this population. The aim of this study was to evaluate the impact of antipsychotics on the prevalence and types of urinary incontinence as well as the impact on women's quality of life, in order to provide up-to-date information, raise awareness and promote treatment and life quality improvement in these patients. Study design: In this comparative study, we investigated the urinary symptoms of 100 women treated with antipsychotic medications as compared to an age-matched, same size, control group. We focused on mentally stable women between the ages of 20 to 40, before the frequency of urinary incontinence rises. Participants completed medical and ICIQ-SF questionnaires regarding urinary symptoms and their effects on life quality. Results: Twenty–nine percent of women in the treatment group experienced urinary incontinence, compared to 13 % in the control group (P < 0.005). Urge incontinence was observed in 24 % and 6 % of the study and control groups respectively (P < 0.001). SUI in the treatment group was twice higher than that of the control group. (p = 0.04). Mixed incontinence was in 13 % of the patients in the study group vs. 2 % in the control group (p = 0.003). Nocturia was prevalent in 15 % vs. 3 % in the treatment vs. control group (P < 0.003). Nocturnal enuresis was observed in 12 % and 2 % in the treatment vs. control group (P < 0.006). Among women with nocturnal enuresis, 5 out of 12 patients were treated with Clozapine (P < 0.001). We found a significant impact of the urinary incontinence symptoms and especially of nocturnal enuresis on quality of life, as assessed by the ICIQ-SF questionnaire, yet only a third of these patients sought treatment for this problem. Conclusion: Urinary incontinence affects approximately a third of young women treated with antipsychotics, with a high incidence of urge and mixed urinary incontinence, nocturia, and nocturnal enuresis and significantly impacts their quality of life. Proactive approach, proper diagnosis and treatment options should be offered to these patients.