Life-Threatening Constipation Associated with Clozapine

  title={Life-Threatening Constipation Associated with Clozapine},
  author={Sanil Rege and Tim Lafferty},
  journal={Australasian Psychiatry},
  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… Expand
Life-threatening haematemesis associated with clozapine: a case report and literature review
Psychiatrists and other medical specialists need to be alert to the fatality of clozapine-induced haematemesis in the treatment of psychiatric disorders. Expand
Treatment of clozapine-induced constipation with bethanechol.
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. Expand
Reintroduction of Clozapine After Perforation of the Large Intestine—A Case Report and Review of the Literature
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. Expand
Clozapine-Induced Constipation: A Case Report and Review of Current Management Guidelines
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. Expand
Gastrointestinal hypomotility: an under-recognised life-threatening adverse effect of clozapine.
AIM To highlight some problems that may occur when investigating clozapine-associated deaths including (i) that death may be related to gastrointestinal hypomotility and (ii) that post-mortem bloodExpand
Antipsychotic-Induced Constipation: A Review of the Pathogenesis, Clinical Diagnosis, and Treatment
The aim of this paper is to review the latest research on the epidemiology, clinical examination methods, pathophysiology, and treatment options and preventive measures for antipsychotic-induced constipation. Expand
Clozapine induced gastrointestinal hypomotility: A potentially life threatening adverse event. A review of the literature.
Clinical features along with preventative and treatment options for clozapine related gastrointestinal disorders in humans and risk factors for CIGH appear to be older age, male gender, patients in the first four months of treatment, co-prescription of constipating agents, higher daily dose of clozAPine, and previous CIGH. Expand
Prucalopride for the Treatment of Clozapine Induced Constipation: A Case Report
Clozapine is an atypical antipsychotic that is classically used for treatment resistant schizophrenia. It’s efficacy in treating treatment resistant patients has been proven [1]. However, Clozapine’sExpand
Prevalence and severity of antipsychotic related constipation in patients with schizophrenia: a retrospective descriptive study
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. Expand
Gastrointestinal Hypomotility and Dysphagia
Antipsychotics, particularly clozapine, and patient life-style, can lead to constipation, which may have life-threatening consequences, obstruction, fecal impaction, and ileus. Patients with theseExpand


Death from clozapine-induced constipation: case report and literature review.
A further death secondary to clozapineinduced constipation and fecal impaction is described, believed to be the fifth fatality described in the literature. Expand
Case report: rapidly fatal bowel ischaemia on clozapine treatment
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. Expand
[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. TheExpand
Toxic Delirium with Low-Dose Clozapine
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. Expand
Reducing clozapine-related morbidity and mortality: 5 years of experience with the Clozaril National Registry.
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. Expand
Delirium associated with clozapine and benzodiazepine combinations.
The combination of benzodiazepines and clozapine should be avoided if possible, and if they are used in combination, it should be with great caution. Expand
Practice guidelines for the management of constipation in adults.
  • S. Folden
  • Medicine
  • Rehabilitation nursing : the official journal of the Association of Rehabilitation Nurses
  • 2002
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. Expand
Delirium during clozapine treatment: incidence and associated risk factors.
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. Expand
Pain insensitivity in schizophrenia: a neglected phenomenon and some implications.
  • R. Dworkin
  • Psychology, Medicine
  • Schizophrenia bulletin
  • 1994
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. Expand
Dietary intake of schizophrenic patients in Nithsdale, Scotland: case-control study
The move to community care means that most schizophrenic patients now live outside hospital. Patients in the community are supported in various ways—for example, through drugs and nursing support.Expand