Rege Sanil, Lafferty Tim
Consultation Liaison Psychiatry, Wyong Mental Health Unit, Wyong Hospital, NSW, Australia.
Australas Psychiatry. 2008 Jun;16(3):216-9. doi: 10.1080/10398560701882203.
The aim of this paper was to describe the association of clozapine with life-threatening constipation.
Case report.
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 was gradually reintroduced with concurrent laxative administration, which resulted in another episode of severe constipation with faecal impaction.
Clozapine can be associated with potentially life-threatening constipation. Psychiatrists, especially consultation liaison psychiatrists, physicians, surgeons and radiologists, should be aware of the seriousness of clozapine-induced constipation and its potentially fatal complications.
本文旨在描述氯氮平与危及生命的便秘之间的关联。
病例报告。
一名53岁男性因分裂情感性障碍服用氯氮平一年多后，因严重腹痛和胆汁性呕吐被送往急诊科。手术显示大肠和小肠存在严重的粪便嵌塞。停用氯氮平。随后的精神科管理出现了重大困难。在同时给予泻药的情况下逐渐重新引入氯氮平，这导致了另一例严重便秘伴粪便嵌塞。
氯氮平可能与潜在危及生命的便秘有关。精神科医生，尤其是会诊联络精神科医生、内科医生、外科医生和放射科医生，应意识到氯氮平所致便秘的严重性及其潜在的致命并发症。
