Acute Colonic Pseudo-obstruction: A Rare but Dangerous Complication of Clozapine Therapy

Constipation is a well-known and usually benign side effect of antipsychotic therapy; however, clozapine-induced gastrointestinal hypomotility can be associated with significant morbidity. Acute colonic pseudo-obstruction (ACPO), or Ogilvie’s syndrome, is a functional obstruction of the colon leading to decreased intestinal motility due to autonomic dysregulation.

Implementation of a clinician administered bowel movement questionnaire for the assessment of clozapine-induced constipation (CIC)

Clozapine, an atypical antipsychotic, is known to cause severe constipation, which can lead to bowel impaction, ischemic bowel, fecal vomitus, and even death. Monitoring suggestions for constipation caused by clozapine are minimal. The intent of this study is to evaluate the possible benefit of implementing a routine monitoring questionnaire to assess for clozapine-induced constipation (CIC).

Comparative gene expression study of the chronic exposure to clozapine and haloperidol in rat frontal cortex.

Fatemi SH, Folsom TD, Reutiman TJ, Novak J, Engel RH. Comparative gene expression study of the chronic exposure to clozapine and haloperidol in rat frontal cortex. Schizophrenia Res. 2012;134(2-3):211-8. DOI: 10.1016/j.schres.2011.11.013. PubMed PMID: 22154595.

Effect of PDE10A inhibitors on MK-801-induced immobility in the forced swim test.

Langen B, Dost R, Egerland U, Stange H, Hoefgen N. Effect of PDE10A inhibitors on MK-801-induced immobility in the forced swim test. Psychopharmacology. 2012;221(2):249-59. DOI: 10.1007/s00213-011-2567-y. PubMed PMID: 22147257.

When can patients with potentially life-threatening adverse effects be rechallenged with clozapine? A systematic review of the published literature.

Manu P, Sarpal D, Muir O, Kane JM, Correll CU. When can patients with potentially life-threatening adverse effects be rechallenged with clozapine? A systematic review of the published literature. Schizophrenia Res. 2012;134(2-3):180-6. DOI: 10.1016/j.schres.2011.10.014. PubMed PMID: 22113154; PubMed Central PMCID: PMC3318984.

Involvement of histamine receptors in the atypical antipsychotic profile of clozapine: a reassessment in vitro and in vivo.

Humbert-Claude M, Davenas E, Gbahou F, Vincent L, Arrang J-M. Involvement of histamine receptors in the atypical antipsychotic profile of clozapine: a reassessment in vitro and in vivo. Psychopharmacology. 2012;220(1):225-41. DOI: 10.1007/s00213-011-2471-5. PubMed PMID: 21912901.

The putative functional rs1045881 marker of neurexin-1 in schizophrenia and clozapine response.

Lett TAP, Tiwari AK, Meltzer HY, Lieberman JA, Potkin SG, Voineskos AN, et al. The putative functional rs1045881 marker of neurexin-1 in schizophrenia and clozapine response. Schizophrenia Res. 2011;132(2-3):121-4. DOI: 10.1016/j.schres.2011.08.007. PubMed PMID: 21890328.

Immediate-release oxybutynin for the treatment of clozapine-induced sialorrhea.

Leung JG, Puri NV, Jacobson MJ. Immediate-release oxybutynin for the treatment of clozapine-induced sialorrhea. Ann Pharmacother. 2011;45(9):e45. DOI: 10.1345/aph.1Q270. PubMed PMID: 21852588.

Adjunct minocycline to clozapine treated patients with persistent schizophrenia symptoms.

Kelly DL, Vyas G, Richardson CM, Koola M, McMahon RP, Buchanan RW, et al. Adjunct minocycline to clozapine treated patients with persistent schizophrenia symptoms. Schizophrenia Res. 2011;133(1-3):257-8. DOI: 10.1016/j.schres.2011.08.005. PubMed PMID: 21872445.

Pimozide Augmentation of Clozapine Inpatients with Schizophrenia and Schizoaffective Disorder Unresponsive to Clozapine Monotherapy

Friedman JI, Lindenmayer J-P, Alcantara F, Bowler S, Parak M, White L, et al. Pimozide Augmentation of Clozapine Inpatients with Schizophrenia and Schizoaffective Disorder Unresponsive to Clozapine Monotherapy. Neuropsychopharmacology. 2011;36(10):2150- 2150. DOI: 10.1038/npp.2011.68.