Alberta Innovates Heritage Youth Researcher Summer Program, University of Calgary, Calgary, AB, Canada.
Mathison Centre for Mental Health Research & Education, Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Department of Psychiatry, University of Calgary, Calgary, AB, Canada; Department of Physiology & Pharmacology, University of Calgary, Calgary, AB, Canada.
Psychiatry Res. 2020 Aug;290:113048. doi: 10.1016/j.psychres.2020.113048. Epub 2020 May 16.
Clozapine-induced gastrointestinal hypomotility (CIGH) is poorly understood and potentially life-threatening. Herein, we present trends of CIGH annual reporting and explore factors associated with a fatal outcome using 25-years of pharmacovigilance data in Canada. Since 1993, the number of CIGH reports increased 22-fold but the proportion of fatal reports remained relatively stable. Fatal reports of CIGH were associated with older age but not sex, clozapine dose, or clozapine duration. Concomitant use of medications used to treat CIGH (lactulose, docusate sodium) and its associated pain/discomfort (acetaminophen, lorazepam) were more commonly reported in fatal cases. Confirmatory and prospective studies of CIGH are warranted.
氯氮平引起的胃肠动力低下（CIGH）的发病机制尚不清楚，且可能危及生命。本研究通过加拿大 25 年的药物警戒数据，分析了 CIGH 年度报告的趋势，并探讨了与致命结局相关的因素。自 1993 年以来，CIGH 报告的数量增加了 22 倍，但致命报告的比例相对稳定。CIGH 的致命报告与年龄较大有关，但与性别、氯氮平剂量或氯氮平持续时间无关。在致命病例中，更常报告同时使用治疗 CIGH 的药物（乳果糖、多库酯钠）及其相关的疼痛/不适（对乙酰氨基酚、劳拉西泮）。需要进行 CIGH 的确认性和前瞻性研究。
