Managing Recurrent Clozapine-Induced Constipation in a Patient with Resistant Schizophrenia

Clozapine is an effective antipsychotic for the treatment of resistant schizophrenia. However, clozapine can lead to serious side effects. One of the most common side effects is constipation and in rare cases ileus, which is associated with a considerable case fatality rate. Our patient exhibited re...

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Autores principales:	Silviu Tomulescu, Kim Uittenhove, Reda Boukakiou
Formato:	article
Lenguaje:	EN
Publicado:	Hindawi Limited 2021
Materias:	Psychiatry RC435-571
Acceso en línea:	https://doaj.org/article/5645e00ec8ff4921ada0f017908f9f9d
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spelling	oai:doaj.org-article:5645e00ec8ff4921ada0f017908f9f9d2021-11-22T01:10:10ZManaging Recurrent Clozapine-Induced Constipation in a Patient with Resistant Schizophrenia2090-683810.1155/2021/9649334https://doaj.org/article/5645e00ec8ff4921ada0f017908f9f9d2021-01-01T00:00:00Zhttp://dx.doi.org/10.1155/2021/9649334https://doaj.org/toc/2090-6838Clozapine is an effective antipsychotic for the treatment of resistant schizophrenia. However, clozapine can lead to serious side effects. One of the most common side effects is constipation and in rare cases ileus, which is associated with a considerable case fatality rate. Our patient exhibited repeated episodes of ileus while being treated with clozapine. We adapted the treatment of the patient in several ways to manage these severe side effects. First, we reduced clozapine dosage by opting for an augmentation strategy of clozapine through paliperidone. Then, we added linaclotide as a nonconventional laxative. We further adapted treatment after the occurrence of a volvulus prompting surgical intervention which revealed a malformation of the intestines’ peritoneal attachment. A gastrostomy to facilitate the treatment of any further episode was performed and bethanechol was introduced alongside linaclotide. Follow-up revealed the efficacy of our strategy involving the use of linaclotide in managing the side effects of clozapine in this patient.Silviu TomulescuKim UittenhoveReda BoukakiouHindawi LimitedarticlePsychiatryRC435-571ENCase Reports in Psychiatry, Vol 2021 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Psychiatry RC435-571
spellingShingle	Psychiatry RC435-571 Silviu Tomulescu Kim Uittenhove Reda Boukakiou Managing Recurrent Clozapine-Induced Constipation in a Patient with Resistant Schizophrenia
description	Clozapine is an effective antipsychotic for the treatment of resistant schizophrenia. However, clozapine can lead to serious side effects. One of the most common side effects is constipation and in rare cases ileus, which is associated with a considerable case fatality rate. Our patient exhibited repeated episodes of ileus while being treated with clozapine. We adapted the treatment of the patient in several ways to manage these severe side effects. First, we reduced clozapine dosage by opting for an augmentation strategy of clozapine through paliperidone. Then, we added linaclotide as a nonconventional laxative. We further adapted treatment after the occurrence of a volvulus prompting surgical intervention which revealed a malformation of the intestines’ peritoneal attachment. A gastrostomy to facilitate the treatment of any further episode was performed and bethanechol was introduced alongside linaclotide. Follow-up revealed the efficacy of our strategy involving the use of linaclotide in managing the side effects of clozapine in this patient.
format	article
author	Silviu Tomulescu Kim Uittenhove Reda Boukakiou
author_facet	Silviu Tomulescu Kim Uittenhove Reda Boukakiou
author_sort	Silviu Tomulescu
title	Managing Recurrent Clozapine-Induced Constipation in a Patient with Resistant Schizophrenia
title_short	Managing Recurrent Clozapine-Induced Constipation in a Patient with Resistant Schizophrenia
title_full	Managing Recurrent Clozapine-Induced Constipation in a Patient with Resistant Schizophrenia
title_fullStr	Managing Recurrent Clozapine-Induced Constipation in a Patient with Resistant Schizophrenia
title_full_unstemmed	Managing Recurrent Clozapine-Induced Constipation in a Patient with Resistant Schizophrenia
title_sort	managing recurrent clozapine-induced constipation in a patient with resistant schizophrenia
publisher	Hindawi Limited
publishDate	2021
url	https://doaj.org/article/5645e00ec8ff4921ada0f017908f9f9d
work_keys_str_mv	AT silviutomulescu managingrecurrentclozapineinducedconstipationinapatientwithresistantschizophrenia AT kimuittenhove managingrecurrentclozapineinducedconstipationinapatientwithresistantschizophrenia AT redaboukakiou managingrecurrentclozapineinducedconstipationinapatientwithresistantschizophrenia
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Managing Recurrent Clozapine-Induced Constipation in a Patient with Resistant Schizophrenia

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