The Porirua Protocol in the Treatment of Clozapine-Induced Gastrointestinal Hypomotility and Constipation: A Pre- and Post-Treatment Study

@article{EveryPalmer2016ThePP,
  title={The Porirua Protocol in the Treatment of Clozapine-Induced Gastrointestinal Hypomotility and Constipation: A Pre- and Post-Treatment Study},
  author={Susanna Every-Palmer and Pete M. Ellis and Michael Nowitz and James Stanley and Eve Grant and Mark Huthwaite and Helen Dunn},
  journal={CNS Drugs},
  year={2016},
  volume={31},
  pages={75-85}
}
AbstractBackgroundClozapine, an antipsychotic used in treatment-resistant schizophrenia, causes slow gastrointestinal transit in 50–80% of patients. [] Key MethodMethodUsing a well-validated radiopaque marker (‘Metcalf’) method, we compared colonic transit times (CTTs) of clozapine-treated inpatients not receiving laxatives with their transit times when receiving laxatives, with treatment prescribed according to the Porirua Protocol for clozapine-related constipation (docusate and senna augmented by macrogol…

Clozapine-Induced Gastrointestinal Hypomotility: A 22-Year Bi-National Pharmacovigilance Study of Serious or Fatal ‘Slow Gut’ Reactions, and Comparison with International Drug Safety Advice

This is the largest study to date of serious clozapine-induced gastrointestinal hypomotility (CIGH) and current prescribing guidelines provide inadequate information on CIGH, contributing to poor awareness and high associated morbidity and mortality.

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Clozapine and Gastrointestinal Hypomotility

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  • 2017
Prevention of GIH can best be obtained by frequent and targeted questioning by the mental healthcare providers of the patients’ defecation pattern and this is therefore strongly recommended for timely detection and treatment of treatment-emergent GIH throughout clozapine treatment.

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All published and unpublished randomised controlled trials investigating the efficacy of pharmacological treatments in patients with antipsychotic-related constipation investigated, finding glycerol laxative was less effective in relieving constipation than rhubarb soda or phenolphthalein.

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Effects of Clozapine on the Gut: Cross-Sectional Study of Delayed Gastric Emptying and Small and Large Intestinal Dysmotility

While the constipating properties of clozapine are now well recognised, this study shows a high degree of vigilance is required for both lower and upper gastrointestinal dysmotility in people taking this antipsychotic.

Clozapine and Gastrointestinal Hypomotility

  • D. Cohen
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Pharmacological treatment for antipsychotic-related constipation.

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