Prevalence and Predictors of Clozapine-Associated Constipation: A Systematic Review and Meta-AnalysisReportar como inadecuado




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1

GKT School of Medical Education Department, King’s College London University, London SE1 1UL, UK

2

Health Service and Population Research Department, Institute of Psychiatry, Kings College London, De Crespigny Park, London SE5 8AF, UK

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Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London SE5 8AZ, UK

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Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London SE5 8AF, UK

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National Psychosis Unit, South London and Maudsley NHS Foundation Trust, London BR3 3BX, UK

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Toxicology Unit, Department of Clinical Biochemistry, King’s College Hospital NHS Foundation Trust, Denmark Hill, London SE5 9RS, UK





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Author to whom correspondence should be addressed.



Academic Editor: Domenico De Berardis

Abstract Constipation is a frequently overlooked side effect of clozapine treatment that can prove fatal. We conducted a systematic review and meta-analysis to estimate the prevalence and risk factors for clozapine-associated constipation. Two authors performed a systematic search of major electronic databases from January 1990 to March 2016 for articles reporting the prevalence of constipation in adults treated with clozapine. A random effects meta-analysis was conducted. A total of 32 studies were meta-analyzed, establishing a pooled prevalence of clozapine-associated constipation of 31.2% 95% CI: 25.6–37.4 n = 2013. People taking clozapine were significantly more likely to be constipated versus other antipsychotics OR 3.02 CI: 1.91–4.77, p < 0.001, n = 11 studies. Meta-regression identified two significant study-level factors associated with constipation prevalence: significantly higher p = 0.02 rates of constipation were observed for those treated in inpatient versus outpatient or mixed settings and for those studies in which constipation was a primary or secondary outcome measure 36.9% compared to studies in which constipation was not a specified outcome measure 24.8%, p = 0.048. Clozapine-associated constipation is common and approximately three times more likely than with other antipsychotics. Screening and preventative strategies should be established and appropriate symptomatic treatment applied when required. View Full-Text

Keywords: constipation; clozapine; treatment-resistant schizophrenia; adverse events; systematic review; meta-analysis constipation; clozapine; treatment-resistant schizophrenia; adverse events; systematic review; meta-analysis





Autor: Ayala Shirazi 1, Brendon Stubbs 2,3, Lucia Gomez 1, Susan Moore 4, Fiona Gaughran 4,5, Robert J. Flanagan 6, James H. MacCabe 4,5 and John Lally 4,5,*

Fuente: http://mdpi.com/



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