Life-Threatening Constipation Associated with Clozapine

@article{Rege2008LifeThreateningCA,
  title={Life-Threatening Constipation Associated with Clozapine},
  author={Sanil Rege and Tim Lafferty},
  journal={Australasian Psychiatry},
  year={2008},
  volume={16},
  pages={216 - 219}
}
Objective: The aim of this paper was to describe the association of clozapine with life-threatening constipation. Method: Case report. Results: A 53-year-old man presented to the emergency department with severe abdominal pain and bilious vomiting after being on clozapine for over a year for schizoaffective disorder. Surgery revealed severe faecal impaction in the large and small bowel. Clozapine was ceased. There were significant difficulties in the subsequent psychiatric management. Clozapine… 
View on SAGE
ncbi.nlm.nih.gov
25 Citations
Highly Influential Citations
2
Background Citations
11

Figures from this paper

25 Citations

Life-threatening haematemesis associated with clozapine: a case report and literature review
TLDR
Psychiatrists and other medical specialists need to be alert to the fatality of clozapine-induced haematemesis in the treatment of psychiatric disorders.
Treatment of clozapine-induced constipation with bethanechol.
TLDR
A patient with refractory schizophrenia for whom clozapine was the only reasonable treatment is reported, who developed severe constipation and a bowel obstruction that was not preventable with conventional laxatives but was able to continue clozAPine when bethanechol, a muscarinic agonist, was added.
Reintroduction of Clozapine After Perforation of the Large Intestine—A Case Report and Review of the Literature
TLDR
The evidence is too weak to draw a definitive conclusion about reintroduction of this drug, but reintroduction of clozapine after initial adverse effects in patients with treatment-resistant schizophrenia may warrant case-by-case judgment.
Clozapine-Induced Constipation: A Case Report and Review of Current Management Guidelines
TLDR
A case report of clozapine-induced constipation is documented and future directions and guidelines should be developed for early diagnosis and treatment for CIC, which will provide reassurance and directions for both the physicians and patients.
Gastrointestinal hypomotility: an under-recognised life-threatening adverse effect of clozapine.
Clozapine induced gastrointestinal hypomotility: A potentially life threatening adverse event. A review of the literature.
Prucalopride for the Treatment of Clozapine Induced Constipation: A Case Report
  • K. Hui
  • Medicine, Psychology
  • 2018
TLDR
If death results from clozapine induced constipation, it would be a tragedy as constipation is a condition that clinicians are in position to influence the outcome and this makes it imperative that death should not be the end result once constipation occurs.
Prevalence and severity of antipsychotic related constipation in patients with schizophrenia: a retrospective descriptive study
TLDR
A high prevalence of constipation, often severe and needing medical interventions, was confirmed during the study period, and early detection, monitoring over treatment and early intervention ofconstipation could prevent serious consequences such as ileus.
Gastrointestinal Hypomotility and Dysphagia
Second-generation antipsychotics and constipation: A review of the literature
...
...

References

SHOWING 1-10 OF 25 REFERENCES
Death from clozapine-induced constipation: case report and literature review.
TLDR
A further death secondary to clozapineinduced constipation and fecal impaction is described, believed to be the fifth fatality described in the literature.
Case report: rapidly fatal bowel ischaemia on clozapine treatment
TLDR
Psychiatrists need to be alert to the medical emergencies which can occur in the context of clozapine treatment and also need to make other clinicians who may have contact with their patients aware of these.
[Current aspects of the use of clozapine in the Châlons-sur-Marne Psychiatric Hospital: intestinal occlusion with clozapine].
The authors report three cases--one of them lethal--of intestinal occlusion among 30 patients treated with clozapine between 1991 and 1994 in Châlons-sur-Marne Psychiatric Hospital. The…
Actualité de l'utilisation de la clozapine à l'Hôpital psychiatrique de Châlons-sur-Marne : occlusions intestinales sous clozapine. Discussion
The authors report three cases--one of them lethal--of intestinal occlusion among 30 patients treated with clozapine between 1991 and 1994 in Châlons-sur-Marne Psychiatric Hospital. The…
Toxic Delirium with Low-Dose Clozapine
TLDR
Nonresponse of this patient to anticholinergic drugs such as diphenhydramine and benztropine mesylate is not surprising as the published reports indicate that the majority of tardive dystonia patients are nonresponsive to these drugs.
Reducing clozapine-related morbidity and mortality: 5 years of experience with the Clozaril National Registry.
TLDR
The estimated impact of the CNR on clozapine-related morbidity and mortality over the first 5 years of commercial experience in the United States is reviewed.
Delirium associated with clozapine and benzodiazepine combinations.
TLDR
The combination of benzodiazepines and clozapine should be avoided if possible, and if they are used in combination, it should be with great caution.
Practice guidelines for the management of constipation in adults.
  • S. Folden
  • Medicine
    Rehabilitation nursing : the official journal of the Association of Rehabilitation Nurses
  • 2002
TLDR
Use of these guidelines, based on the best available scientific knowledge and expert consensus, will facilitate implementation of the most recent research findings and assist practitioners to appropriately prevent and manage problems related to constipation in adults.
Delirium during clozapine treatment: incidence and associated risk factors.
TLDR
Delirium was found in 10 % of clozapine-treated inpatients, particularly in older patients exposed to other central anticholinergics, and was associated with increased length of stay and higher costs, and inferior clinical outcome.
Pain insensitivity in schizophrenia: a neglected phenomenon and some implications.
  • R. Dworkin
  • Psychology, Medicine
    Schizophrenia bulletin
  • 1994
TLDR
It is argued that this widely reported but currently neglected phenomenon has important implications for physical health, self-mutilation, homelessness, premorbid development, and affective flattening in individuals with schizophrenia.
...
...