clozapine and Diarrhea

Constipation is a common and potentially fatal side effect of clozapine treatment. Another important side effect of clozapine may also be significant weight gain. Orlistat is a weight-control medication that is known to induce loose stools as a common side effect. This study aimed to explore whether orlistat used to control clozapine-induced weight gain can simultaneously tackle clozapine-related constipation. In this 16-week randomized-controlled study, clozapine-treated patients received add-on orlistat (n=30) or add-on placebo (n=24). Colonic function was measured using the Bristol Stool Form Scale. There was a significant (P=0.039) difference in the prevalence of constipation in favor of orlistat over placebo in completers (n=40) at the endpoint. A decrease in the prevalence of constipation within the orlistat group (P=0.035) was observed (vs. no statistically significant changes in the placebo group). In clozapine-treated patients, orlistat may be beneficial not only for weight control but also as a laxative. As no established treatments for clozapine-induced constipation exist, orlistat can be considered for this population, although more studies are required.

Topics: Anti-Obesity Agents; Antipsychotic Agents; Benzodiazepines; Clozapine; Colon; Constipation; Cross-Sectional Studies; Diarrhea; Double-Blind Method; Finland; Humans; Incidence; Lactones; Laxatives; Obesity; Olanzapine; Orlistat; Overweight; Patient Dropouts; Prevalence; Psychotic Disorders; Schizophrenia; Severity of Illness Index; Weight Loss

Following the conduct of a 28-day inpatient bioequivalence study of clozapine in schizophrenia patients, withdrawal effects after abrupt discontinuation from clozapine were assessed. Thirty patients who met DSM-III-R criteria for schizophrenia, residual type, or schizophrenia in remission were enrolled in the study. Patients were evaluated for symptoms of withdrawal effects for 7 days after clozapine 200 mg/day was abruptly withdrawn. Of 28 patients who completed the study, 11 had no withdrawal symptoms; 12 had mild withdrawal adverse events of agitation, headache, or nausea; four patients experienced moderate withdrawal adverse events of nausea, vomiting, or diarrhea; and one patient experienced a rapid-onset psychotic episode requiring hospitalization. Cholinergic rebound is a likely explanation for the mild to moderate withdrawal symptoms and is easily treated with an anticholinergic agent. Mesolimbic supersensitivity, as well as specific properties of clozapine, are discussed as likely causes for rapidonset psychosis. Our findings are consistent with previous reports of withdrawal reactions associated with clozapine, further reminding clinicians to monitor patients closely following abrupt discontinuation of clozapine.

Topics: Adolescent; Adult; Akathisia, Drug-Induced; Antipsychotic Agents; Clozapine; Diarrhea; Dose-Response Relationship, Drug; Female; Humans; Male; Middle Aged; Nausea; Neurologic Examination; Psychoses, Substance-Induced; Receptors, Cholinergic; Schizophrenia; Schizophrenic Psychology; Substance Withdrawal Syndrome; Vomiting

Topics: Clozapine; Diarrhea; Humans

Irinotecan (CPT-11) is a cytotoxic drug that has wide applicability and usage in cancer treatment. Despite its success, patients suffer dose-dependent diarrhea, limiting the drug's efficacy. No effective therapy is available for this unmet medical need. The bacterial β-glucuronidase (β-GUS) plays pivotal role in CPT-11-induced diarrhea (CID) via activating the non-toxic SN-38G to toxic SN-38 inside intestine. By using structural-based virtual screening, three old drugs (N-Desmethylclozapine, Aspartame, and Gemifloxacin) were firstly identified as selective bacterial β-GUS inhibitors. The IC

Topics: Antidiarrheals; Aspartame; Bacteria; Bacterial Proteins; Camptothecin; Clozapine; Diarrhea; Drug Evaluation, Preclinical; Enzyme Inhibitors; Escherichia coli; Gemifloxacin; Glucuronates; Glucuronidase; Humans; Irinotecan; Molecular Docking Simulation; Molecular Dynamics Simulation; Protein Binding; Protein Conformation; Structure-Activity Relationship

Topics: Antipsychotic Agents; Blood Sedimentation; Clozapine; Colitis; Diarrhea; Eosinophilia; Fever; Humans; Male; Middle Aged; Schizophrenia

Topics: Adult; Antipsychotic Agents; Clozapine; Diarrhea; Dietary Sucrose; Dose-Response Relationship, Drug; Female; Humans; Hypertonic Solutions; Metabolic Clearance Rate; Schizophrenia; Schizophrenic Psychology; Treatment Refusal

Topics: Adult; Clozapine; Diarrhea; Fever; Humans; Male; Psychotic Disorders

Topics: Adult; Clozapine; Diarrhea; Female; Humans; Leukocyte Count; Lymphocytes; Male; Middle Aged