{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T01:06:35Z","timestamp":1792112795231,"version":"4.4.0"},"reference-count":35,"publisher":"Royal College of Psychiatrists","issue":"6","license":[{"start":{"date-parts":[[2022,2,15]],"date-time":"2022-02-15T00:00:00Z","timestamp":1644883200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Br J Psychiatry"],"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:sec id=\"S0007125022000241_sec_a1\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Clozapine-induced gastrointestinal hypomotility (CIGH) affects some 75% of patients treated with clozapine.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0007125022000241_sec_a2\">\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To document the incidence of potentially harmful CIGH in the UK.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0007125022000241_sec_a3\" sec-type=\"methods\">\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>We studied spontaneous UK pharmacovigilance reports recorded as clozapine-related gastrointestinal adverse drug reactions, 1992\u20132017.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0007125022000241_sec_a4\" sec-type=\"results\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      There were 527 patients reported with potentially harmful CIGH; 33% (\n                      <jats:italic>n<\/jats:italic>\n                      = 172) died. Deaths averaged 1 per year 1992\u20131999, 5 per year 2000\u20132009 and 15 per year 2010\u20132017. Those who died were older (median 52 years\n                      <jats:italic>v.<\/jats:italic>\n                      49 years) and had been prescribed clozapine for longer than those who recovered (median 11.3 years\n                      <jats:italic>v<\/jats:italic>\n                      . 4.8 years), but there was no difference in prescribed dose. Within the first 4 years of clozapine treatment, there were 169 reports of CIGH, of which 3% (\n                      <jats:italic>n<\/jats:italic>\n                      = 5) were fatal. At 10\u201314 years there were 63 reports of CIGH, of which 25% (\n                      <jats:italic>n<\/jats:italic>\n                      = 16) were fatal. Among the deaths, males were younger (median 51, range 22\u201389\n                      <jats:italic>v<\/jats:italic>\n                      . median 57, range 24\u201389 years) with higher clozapine doses (median 450, range 100\u2013900\n                      <jats:italic>v<\/jats:italic>\n                      . median 300, range 12.5\u2013800 mg\/d) than females. In non-fatal CIGH, surgery was the most frequent outcome (\n                      <jats:italic>n<\/jats:italic>\n                      = 92). The procedures included appendectomy, ileostomy, total\/partial colectomy, colostomy\/stoma and proctosigmoidectomy. Clozapine dosage was reduced in 6 patients, stopped and restarted in 23, \u2018continued\u2019 in 6 and discontinued permanently in at least 76 patients.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0007125022000241_sec_a5\" sec-type=\"conclusions\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The risk of serious morbidity\/mortality from CIGH is substantial. The need to actively monitor bowel function and give laxatives to patients treated with clozapine is clear.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1192\/bjp.2022.24","type":"journal-article","created":{"date-parts":[[2022,2,15]],"date-time":"2022-02-15T01:13:28Z","timestamp":1644887608000},"page":"355-363","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":32,"title":["Clozapine-induced gastrointestinal hypomotility: presenting features and outcomes, UK pharmacovigilance reports, 1992\u20132017"],"prefix":"10.1192","volume":"220","author":[{"given":"S. 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