Nocturia, depression and antidepressant medication

To assess the possible relationship between treatment with selective serotonin-reuptake inhibitors (SSRIs) and the occurrence of nocturia.

An unselected group of adult men and women, living in the city of Ostersund, Sweden, were sent a postal questionnaire containing questions on somatic and mental health, sleep, sleepiness and nocturia. For depression diagnostics, the Major Depression Inventory (MDI) was used. Prescription data on antidepressant drugs were extracted from a register in the county of Jamtland, Sweden.

The questionnaire was completed by 1375 subjects, of whom 609 (44%) were men; the response rate was 69%. Prescription data were available for all respondents. The mean (sd) age of the men and women participating were 48.0 (18.2) and 50.1 (19.1) years, respectively. Two or more nocturnal micturition episodes were reported in 15.6% of the men and 16.5% of the women. In a multiple logistic regression analysis, independent correlates for two or more nocturnal voids vs no more than one were: age 45-59 years vs <45 (odds ratio 2.9; 95% confidence interval 1.9-4.7); age 60-74 vs <45 (6.0; 3.7-9.8); age > 75 vs <45 (13.4; 7.9-22.6); major depression, yes vs no (4.6; 2.8-7.5); and being on treatment with SSRI, yes vs no (2.2; 1.1-4.5). Gender was deleted by the logistic regression model.

Major depression has previously been found to be associated with increased nocturnal micturition. In the present study, twice as many men and women treated with SSRIs as those not so treated had two or more nocturnal voids, after adjusting for major depression and age. The implication for the risk of fall injuries is discussed.