Kawamata Yasushi, Sugawara Norio, Sasaki Taro, Yokoyama Saaya, Okayasu Hiroaki, Shinozaki Masataka, Takeuchi Yoshitaka, Sato Aoi, Ishikawa Takaaki, Komahashi-Sasaki Hazuki, Miyazaki Kensuke, Fukasawa Takashi, Furukori Hanako, Yasui-Furukori Norio
Department of Psychiatry, School of Medicine, Dokkyo Medical University, Tochigi, Japan.
Department of Psychiatry, Kikuchi Hospital, Tochigi, Japan.
Neuropsychopharmacol Rep. 2024 Mar;44(1):60-66. doi: 10.1002/npr2.12378. Epub 2023 Sep 12.
Constipation is a common adverse effect of antipsychotics, but little investigation has been conducted. We aimed to address the factors associated with the initiation of laxative use in the same patients with schizophrenia over a 20-year period.
We enrolled patients with schizophrenia attending each hospital (n = 14) from April 1, 2021, and retrospectively examined all prescriptions as of April 1, 2016, 2011, 2006, and 2001, every 5 years starting in 2021, for this population. 716 participants with complete data were included in the analysis. The Cochran Q test followed by Bonferroni correction and the Cochran-Armitage trend test were used to determine the differences and trends of the frequency of each laxative. Multivariate logistic regression analysis was performed to assess the factors on the initiation of laxative use over a 20-year period.
Of the patients, 25.1% were treated with laxatives in 2001, and 34.1% were treated in 2021. The numbers of patients treated with any laxatives significantly differed over the 20-year period, with a significant increasing trend. In all laxatives, the numbers of patients treated with magnesium oxide, lubiprostone and elobixibat differed with a significant increasing trend. Female sex, age, the total DZP equivalent dose, and the doses of levomepromazine maleate, olanzapine, quetiapine, zotepine, lithium, and carbamazepine in 2021 were significant factors associated with the initiation of laxative use over the 20-year period.
Careful monitoring is needed for patients treated with levomepromazine maleate, olanzapine, quetiapine and zotepine. Optimizing prescriptions according to treatment guidelines could reduce antipsychotic-induced constipation.
便秘是抗精神病药物常见的不良反应，但相关研究较少。我们旨在探讨20年间同一组精神分裂症患者开始使用泻药的相关因素。
我们纳入了自2021年4月1日起在各医院就诊的精神分裂症患者（n = 14），并回顾性检查了从2021年开始每5年（即截至2016年4月1日、2011年4月1日、2006年4月1日和2001年4月1日）该人群的所有处方。716名有完整数据的参与者被纳入分析。采用Cochran Q检验及Bonferroni校正和Cochran-Armitage趋势检验来确定每种泻药使用频率的差异和趋势。进行多变量逻辑回归分析以评估20年间开始使用泻药的相关因素。
2001年，25.1%的患者接受了泻药治疗，2021年这一比例为34.1%。在这20年间，使用任何泻药治疗的患者数量有显著差异，且呈显著上升趋势。在所有泻药中，使用氧化镁、鲁比前列酮和埃洛昔巴特治疗的患者数量有差异且呈显著上升趋势。女性、年龄、2021年地西泮等效总剂量以及马来酸左美丙嗪、奥氮平、喹硫平、氯氮平、锂和卡马西平的剂量是20年间开始使用泻药的显著相关因素。
对于接受马来酸左美丙嗪、奥氮平、喹硫平及氯氮平治疗的患者需要进行密切监测。根据治疗指南优化处方可减少抗精神病药物所致便秘。
