clozapine and Dyspepsia

We report on dyspeptic complaints among patients hospitalized in the long-stay ward of a general psychiatric hospital.. A representative sample of the patients was interviewed using a structured questionnaire.. Eighty percent of the patients reported one or more symptoms of dyspepsia, and 68 % reported symptoms of reflux-like dyspepsia.. Significant positive associations were found for dyspepsia complaints and clozapine (OR = 3.4), laxatives (OR = 4.4), and heavy smoking (OR = 2.3).

Topics: Adult; Aged; Aged, 80 and over; Antipsychotic Agents; Cathartics; Chronic Disease; Clozapine; Confidence Intervals; Dyspepsia; Female; Humans; Male; Mental Disorders; Middle Aged; Odds Ratio; Sex Factors; Smoking

Constipation and dyspepsia are disturbing gastrointestinal symptoms that are often ignored in research on physical comorbidities of schizophrenia. The aim was to assess dyspepsia and constipation in a sample of outpatients with schizophrenia spectrum psychoses. A general practitioner performed a thorough physical health check for 275 outpatients and diagnosed constipation and dyspepsia. This study assessed the possible contribution of several sociodemographic, lifestyle, and clinical variables to constipation and dyspepsia using logistic regression analysis. This study also assessed whether these symptoms were associated with abnormal laboratory findings. The prevalence of constipation was 31.3%, and of dyspepsia 23.6%. Paracetamol (OR =3.07, 95% CI =1.34-7.02) and clozapine use (OR =5.48, 95% CI =2.75-10.90), older age (OR =1.04, 95% CI =1.01-1.06), and living in sheltered housing (OR =2.49, 95% CI =1.16-5.33) were risk factors for constipation. For dyspepsia the risk factors were female sex (OR =2.10, 95% CI =1.15-3.83), non-steroidal anti-inflammatory drugs (OR =2.47, 95% CI =1.13-5.39), and diabetes medication (OR =2.42, 95% CI =1.12-5.25). Patients with dyspepsia had lower haemoglobin and haematocrit and higher glucose values than those without dyspepsia. Patients with constipation had lower thrombocyte values than patients without constipation. However, these findings were explained by factors pre-disposing to constipation and dyspepsia. Clozapine use markedly increases the risk of constipation and may lead to life-threatening complications. In addition, analgesics and diabetes medication were related to gastrointestinal symptoms. These medications and their association to gastrointestinal symptoms should be kept in mind when treating patients with schizophrenia.

Topics: Adult; Analgesics; Antipsychotic Agents; Clozapine; Comorbidity; Constipation; Diabetes Mellitus; Dyspepsia; Female; Humans; Male; Schizophrenia