Fatalities associated with clozapine-related constipation and bowel obstruction: a literature review and two case reports

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.