Sazhin Vladimir, Pushkal Pushkal
Consultant Psychiatrist, Macquarie Hospital (Northern Sydney Local Health District), North Ryde, NSW, Australia.
Advanced Trainee in Psychiatry, Northern Sydney and Central Coast Local Health Districts, Gosford, NSW, Australia.
Australas Psychiatry. 2022 Feb;30(1):105-109. doi: 10.1177/10398562211042368. Epub 2021 Oct 27.
Constipation, a clinical manifestation of gastrointestinal hypomotility, is a common and potentially serious complication of clozapine therapy, requiring laxatives for its prevention and treatment. We explored the predictive factors of the increased laxative use in inpatients receiving a long-term clozapine therapy.
In the cross-sectional study of 93 patients in a psychiatric rehabilitation hospital, we examined a four-week prevalence of laxative use and a range of demographic and clinical factors associated with the number of prescribed laxatives.
Seventy-four percent of inpatients with schizophrenia were prescribed laxatives, and they were statistically significant older and taking higher daily doses of clozapine. In generalized Poisson regression analysis, the clozapine dose, age, and comorbid diabetes mellitus and hypothyroidism were independently associated with the number of concurrently used laxatives. No association was found between the laxatives and gender, duration of clozapine treatment, and the number of other medications with a potential to cause constipation.
The clozapine dose, age, diabetes mellitus, and hypothyroidism were shown to be the independent predictors of the increased laxative use among inpatients on clozapine and might be associated with the increased risk of clozapine-induced constipation and gastrointestinal hypomotility.
便秘是胃肠动力不足的一种临床表现，是氯氮平治疗常见且可能严重的并发症，预防和治疗便秘需要使用泻药。我们探讨了长期接受氯氮平治疗的住院患者泻药使用增加的预测因素。
在一家精神康复医院对93例患者进行的横断面研究中，我们调查了四周内泻药的使用情况以及一系列与泻药处方数量相关的人口统计学和临床因素。
74%的精神分裂症住院患者被处方使用泻药，且他们在统计学上年龄更大，每日服用氯氮平的剂量更高。在广义泊松回归分析中，氯氮平剂量、年龄、合并糖尿病和甲状腺功能减退与同时使用泻药的数量独立相关。未发现泻药与性别、氯氮平治疗时长以及其他可能导致便秘的药物数量之间存在关联。
氯氮平剂量、年龄、糖尿病和甲状腺功能减退被证明是氯氮平治疗住院患者泻药使用增加的独立预测因素，可能与氯氮平引起便秘及胃肠动力不足的风险增加有关。
