ReviewCNS drugs2017
Clozapine and Gastrointestinal Hypomotility.
Review in CNS drugs, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
19 citing papers in PubMed, 2 syntheses or guidelines pooled it, 48 citations in OpenAlex.
- Clozapine Optimization: A Delphi Consensus Guideline From the Treatment Response and Resistance in Psychosis Working Group.Schizophrenia bulletin · 2023Guideline
- A Guideline and Checklist for Initiating and Managing Clozapine Treatment in Patients with Treatment-Resistant Schizophrenia.CNS drugs · 2022Guideline
- Effects of Clozapine on the Gut: Cross-Sectional Study of Delayed Gastric Emptying and Small and Large Intestinal Dysmotility.CNS drugs · 2019Trial
- Severe antipsychotic-associated gastrointestinal hypomotility: AMSP pharmacovigilance data from 333,175 psychiatric inpatients.European archives of psychiatry and clinical neuroscience · 2026Article
- Review
- Higher risk of gastrointestinal stenosis and obstruction in clozapine-treated individuals with schizophrenia: a pharmacovigilance study based on the FDA adverse event reporting system database.Naunyn-Schmiedeberg's archives of pharmacology · 2026Article
- A clinical decision support alert to promote timely laxative use in in-patients prescribed clozapine.BJPsych open · 2025Article
- Drug-Drug Interactions and Individualized Clozapine Therapy in Patients with Depression: Insights from Real-World Data.Drug design, development and therapy · 2025Article
- Optimization of protocols for immunohistochemical assessment of enteric nervous system in formalin fixed human tissue.bioRxiv : the preprint server for biology · 2024Article
- Clozapine-associated adverse drug reactions in 38,349 psychiatric inpatients: drug surveillance data from the AMSP project between 1993 and 2016.Journal of neural transmission (Vienna, Austria : 1996) · 2024Observational
- Paralytic ileus in a patient on clozapine therapy showing an inverted clozapine/norclozapine ratio after switching valproic acid to carbamazepine: a case report.Therapeutic advances in psychopharmacology · 2024Article
- Study on clinical characteristics and related factors of schizophrenic patients with intestinal obstruction.BMC gastroenterology · 2022Article
- Characteristics associated with self-reported medication adherence in persons with psychosis referred to psychosocial rehabilitation centers.European archives of psychiatry and clinical neuroscience · 2021Article
- Prescription attitudes and practices regarding clozapine among Serbian psychiatrists: results of a nationwide survey.Therapeutic advances in psychopharmacology · 2021Article
- Clozapine in the treatment of refractory schizophrenia: a practical guide for healthcare professionals.British medical bulletin · 2020Article
- Atypical Presentation of Acquired Hypoganglionosis in a Patient Taking Clozapine.Case reports in gastrointestinal medicine · 2020Article
- A Rational Use of Clozapine Based on Adverse Drug Reactions, Pharmacokinetics, and Clinical Pharmacopsychology.Psychotherapy and psychosomatics · 2020Review
- Lethal Acute Colonic Pseudo-Obstruction in a Patient Using a Combination of Olanzapine and Clozapine.Journal of clinical psychopharmacologyArticle
- Letter to the FDA Proposing Major Changes in the US Clozapine Package Insert Supported by Clozapine Experts Worldwide. Part II: A Review of Fatal Outcomes in US Pharmacovigilance Data and Proposed Changes.Journal of clinical psychopharmacologyArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
1 author at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Gastrointestinal hypomotility (GIH) is an under-reported but highly prevalent and potentially dangerous side effect of clozapine. In a comprehensive meta-analysis of clozapine-treated patients, the prevalence of GIH was 32%. In general, GIH has consistently been reported to have a negative impact on quality of life, and there is no reason to believe this will be different in clozapine-treated patients with therapy-resistant schizophrenia. GIH is dangerous; in a comparative review of lethal side effects of clozapine, the mortality of agranulocytosis was 2.2-4.2% compared with 15.0-27.5% for GIH. The mortality rate in our review of all published case reports of ileus was 43.7%. (Co-)Prescription of anticholinergic drugs in patients treated with clozapine should be avoided as anticholinergics are associated with increased incidence and fatality of ileus. Prevention of GIH can best be obtained by frequent and targeted questioning by the mental healthcare providers of the patients' defecation pattern and this is therefore strongly recommended for timely detection and treatment of treatment-emergent GIH throughout clozapine treatment. Treatment approaches can be either preventive laxative prescription with every clozapine prescription in all clozapine-treated patients or targeted treatment of treatment-emergent GIH. First-line treatments of GIH are the osmotic laxative macrogol, stool softener docusate and bowel stimulant senna. As the occurrence of severe cases of GIH is not restricted to a certain treatment duration, alertness for and/or treatment of GIH is required for the whole duration of clozapine treatment.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.