Clozapine-induced constipation is a frequently overlooked side effect that can prove fatal. This study aimed to investigate the prevalence of constipation and the breakdown of laxatives, and to identify whether use of laxative may be predicted by demographics or baseline metabolic markers in 53 Japanese treatment-resistant schizophrenia inpatients switched to clozapine. Differences of present age, onset age and duration of illness, previous antipsychotic dose using the chlorpromazine equivalent, and 10-items of metabolic markers, including fasting plasma glucose and ratio of triglyceride to high-density lipoprotein cholesterol levels were compared between the laxative and nonlaxative user groups. Sequential changes of defecation scores using Bristol stool form scale, and clozapine dosage at 1, 2 and 3 months were evaluated within each group. Multiple linear stepwise regression analysis was performed to assess the predicting use of laxatives. Half of subjects required treatment with laxative, were significantly older and had longer durations of illness than nonlaxative users. Magnesium oxide and lubiprostone were mainly used singly or in combination. Longer disease duration, and lower levels of fasting blood glucose and insulin resistance were predicting the use of laxatives. Screening and preventive strategies for minimizing clozapine-related constipation should be established in future study.

中文翻译：

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氯氮平相关便秘中使用泻药的流行率和预测因素：一项观察性研究。

氯氮平引起的便秘是一种经常被忽视的副作用，可能是致命的。本研究旨在调查便秘的患病率和泻药的分解情况，并确定是否可以通过人口统计学或基线代谢标志物在 53 名改用氯氮平的日本抗药性精神分裂症住院患者中预测使用泻药。比较轻泻剂和非轻泻剂之间的现年龄、发病年龄和病程、既往使用氯丙嗪等效物的抗精神病药剂量以及包括空腹血糖和甘油三酯与高密度脂蛋白胆固醇的比率在内的10项代谢标志物的差异用户组。使用 Bristol 粪便形式量表评估排便评分的顺序变化，并在 1、2 和 3 个月时评估每组中的氯氮平剂量。进行多元线性逐步回归分析以评估轻泻剂的预测使用。一半的受试者需要使用轻泻剂治疗，与非轻泻剂使用者相比，他们的年龄明显更大且患病时间更长。氧化镁和鲁比前列酮主要单独或联合使用。更长的病程、更低的空腹血糖和胰岛素抵抗水平预示着使用泻药。应在未来的研究中制定减少氯氮平相关便秘的筛查和预防策略。氧化镁和鲁比前列酮主要单独或联合使用。更长的病程、更低的空腹血糖和胰岛素抵抗水平预示着使用泻药。应在未来的研究中制定减少氯氮平相关便秘的筛查和预防策略。氧化镁和鲁比前列酮主要单独或联合使用。更长的病程、更低的空腹血糖和胰岛素抵抗水平预示着使用泻药。应在未来的研究中制定减少氯氮平相关便秘的筛查和预防策略。