Antipsychotics induced constipation in patients with mental disorders. treatment suggestion with prucalopride in refractory cases. case report and literature review
Introduction Successful stabilization of patients with mental disorders requires most of the times the use of more than one antipsychotic medications with increase prevalence of clozapine in refractory cases. Constipation consists one of the most debilitating side effect of the therapy, which gradu...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Cambridge University Press
2022-06-01
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| Series: | European Psychiatry |
| Subjects: | |
| Online Access: | https://www.cambridge.org/core/product/identifier/S0924933822020144/type/journal_article |
| _version_ | 1797616458265526272 |
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| author | P. Mpouras P. Argitis O. Pikou A. Karampas S. Karavia F.-E. Kakavitsas Z. Chaviaras |
| author_facet | P. Mpouras P. Argitis O. Pikou A. Karampas S. Karavia F.-E. Kakavitsas Z. Chaviaras |
| author_sort | P. Mpouras |
| collection | DOAJ |
| description |
Introduction
Successful stabilization of patients with mental disorders requires most of the times the use of more than one antipsychotic medications with increase prevalence of clozapine in refractory cases. Constipation consists one of the most debilitating side effect of the therapy, which gradually progresses to a chronic state of bowel movement dysfunction, with recurrent episode of paralytic ileus of various severity.
Objectives
We describe the case of a middle age male treated with clozapine for refractory mental disorder, who developed ileus and subsequent bowel dysfunction not amenable to laxatives.
Methods
The acute episode have been treated conservatively with nasogastric decompression, intravenous replacement of fluids and electrolytes, antibiotics chemoprophylaxis and low molecular weight heparin. His overall physical status was unremarkable for obesity, diabetes, hypertension, allergies, previous operations and a former endoscopic evaluation conducted in the recent past, which had ruled out malignant neoplastic disease.
Results
A course of per os prucalopride have been instituted, which showed preliminary promising results in restoring proper bowel movements, without any serious side effect and without the need to discontinue his course with antipsychotics. Prucalopride is a 5 HT4 agonist which selectively binds to the receptors of the intestine, resulting in muscular contractions as well as clorium secretion from the mucosa promoting an osmotic defecation.The substance has been extensively use in the treatment of irritable bowel disease of the chronic constipation type.
Conclusions
We suggest the more systematic use of this agent in this group of patients after proper endoscopic evaluation and restoration of all secondary causes of constipation.
Disclosure
No significant relationships.
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| first_indexed | 2024-03-11T07:41:32Z |
| format | Article |
| id | doaj.art-b7b974c8cb3844fbbb557946c5e60581 |
| institution | Directory Open Access Journal |
| issn | 0924-9338 1778-3585 |
| language | English |
| last_indexed | 2024-03-11T07:41:32Z |
| publishDate | 2022-06-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | European Psychiatry |
| spelling | doaj.art-b7b974c8cb3844fbbb557946c5e605812023-11-17T05:08:28ZengCambridge University PressEuropean Psychiatry0924-93381778-35852022-06-0165S780S78010.1192/j.eurpsy.2022.2014Antipsychotics induced constipation in patients with mental disorders. treatment suggestion with prucalopride in refractory cases. case report and literature reviewP. Mpouras0P. Argitis1O. Pikou2A. Karampas3S. Karavia4F.-E. Kakavitsas5Z. Chaviaras6General Hospital of Corfu, General Medicine, corfu, GreeceGeneral Hospital of Corfu, Psychiatric, Corfu, GreeceGeneral Hospital of Corfu, Dermatology, corfu, GreeceGeneral Hospital of Corfu, Psychiatric, Corfu, GreeceGeneral Hospital of Corfu, Psychiatric, Corfu, GreeceGeneral Hospital of Corfu, General Medicine, corfu, GreeceGeneral Hospital of Corfu, Psychiatric, Corfu, Greece Introduction Successful stabilization of patients with mental disorders requires most of the times the use of more than one antipsychotic medications with increase prevalence of clozapine in refractory cases. Constipation consists one of the most debilitating side effect of the therapy, which gradually progresses to a chronic state of bowel movement dysfunction, with recurrent episode of paralytic ileus of various severity. Objectives We describe the case of a middle age male treated with clozapine for refractory mental disorder, who developed ileus and subsequent bowel dysfunction not amenable to laxatives. Methods The acute episode have been treated conservatively with nasogastric decompression, intravenous replacement of fluids and electrolytes, antibiotics chemoprophylaxis and low molecular weight heparin. His overall physical status was unremarkable for obesity, diabetes, hypertension, allergies, previous operations and a former endoscopic evaluation conducted in the recent past, which had ruled out malignant neoplastic disease. Results A course of per os prucalopride have been instituted, which showed preliminary promising results in restoring proper bowel movements, without any serious side effect and without the need to discontinue his course with antipsychotics. Prucalopride is a 5 HT4 agonist which selectively binds to the receptors of the intestine, resulting in muscular contractions as well as clorium secretion from the mucosa promoting an osmotic defecation.The substance has been extensively use in the treatment of irritable bowel disease of the chronic constipation type. Conclusions We suggest the more systematic use of this agent in this group of patients after proper endoscopic evaluation and restoration of all secondary causes of constipation. Disclosure No significant relationships. https://www.cambridge.org/core/product/identifier/S0924933822020144/type/journal_articleCONSTIPATIONPRUCALOPRIDE |
| spellingShingle | P. Mpouras P. Argitis O. Pikou A. Karampas S. Karavia F.-E. Kakavitsas Z. Chaviaras Antipsychotics induced constipation in patients with mental disorders. treatment suggestion with prucalopride in refractory cases. case report and literature review European Psychiatry CONSTIPATION PRUCALOPRIDE |
| title | Antipsychotics induced constipation in patients with mental disorders. treatment suggestion with prucalopride in refractory cases. case report and literature review |
| title_full | Antipsychotics induced constipation in patients with mental disorders. treatment suggestion with prucalopride in refractory cases. case report and literature review |
| title_fullStr | Antipsychotics induced constipation in patients with mental disorders. treatment suggestion with prucalopride in refractory cases. case report and literature review |
| title_full_unstemmed | Antipsychotics induced constipation in patients with mental disorders. treatment suggestion with prucalopride in refractory cases. case report and literature review |
| title_short | Antipsychotics induced constipation in patients with mental disorders. treatment suggestion with prucalopride in refractory cases. case report and literature review |
| title_sort | antipsychotics induced constipation in patients with mental disorders treatment suggestion with prucalopride in refractory cases case report and literature review |
| topic | CONSTIPATION PRUCALOPRIDE |
| url | https://www.cambridge.org/core/product/identifier/S0924933822020144/type/journal_article |
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