Abstract
Background:
Constipation is an exceedingly common side effect of treatment with clozapine. In rare cases, this side effect has resulted in fatal complications.
Objective:
The authors review the literature on fatal complications of clozapine-related constipation and bowel obstruction.
Method:
The authors provide two new case reports of patients who died of similar causes.
Results:
There were seven reports of deaths from clozapine-related bowel obstruction in the literature, with the most common mechanisms of death being severe impaction leading either to feculent vomiting or bowel necrosis.
Discussion:
The discussion outlines potential mechanisms and management of clozapine-related constipation.
MeSH terms
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Anticonvulsants / administration & dosage
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Antipsychotic Agents / administration & dosage
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Antipsychotic Agents / adverse effects*
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Clozapine / administration & dosage
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Clozapine / adverse effects*
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Constipation / chemically induced*
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Constipation / mortality*
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Drug Therapy, Combination
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Flurazepam / administration & dosage
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GABA Modulators / administration & dosage
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GABA Modulators / adverse effects
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Glyburide / administration & dosage
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Humans
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Hypoglycemic Agents / administration & dosage
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Intestinal Obstruction / chemically induced*
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Intestinal Obstruction / mortality*
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Intubation, Gastrointestinal / adverse effects
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Lamotrigine
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Male
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Mandelic Acids / administration & dosage
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Middle Aged
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Muscarinic Antagonists / administration & dosage
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Procyclidine / administration & dosage
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Schizophrenia / drug therapy*
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Thyroxine / administration & dosage
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Triazines / administration & dosage
Substances
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Anticonvulsants
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Antipsychotic Agents
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GABA Modulators
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Hypoglycemic Agents
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Mandelic Acids
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Muscarinic Antagonists
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Triazines
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Procyclidine
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Flurazepam
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Clozapine
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oxybutynin
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Thyroxine
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Glyburide
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Lamotrigine