{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T19:33:49Z","timestamp":1792524829652,"version":"4.5.0"},"reference-count":98,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2016,6,2]],"date-time":"2016-06-02T00:00:00Z","timestamp":1464825600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>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\u201337.4) (n = 2013). People taking clozapine were significantly more likely to be constipated versus other antipsychotics (OR 3.02 (CI: 1.91\u20134.77), p &lt; 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.<\/jats:p>","DOI":"10.3390\/ijms17060863","type":"journal-article","created":{"date-parts":[[2016,6,2]],"date-time":"2016-06-02T10:19:08Z","timestamp":1464862748000},"page":"863","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":124,"title":["Prevalence and Predictors of Clozapine-Associated Constipation: A Systematic Review and Meta-Analysis"],"prefix":"10.3390","volume":"17","author":[{"given":"Ayala","family":"Shirazi","sequence":"first","affiliation":[{"name":"GKT School of Medical Education Department, King\u2019s College London University, London SE1 1UL, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brendon","family":"Stubbs","sequence":"additional","affiliation":[{"name":"Health Service and Population Research Department, Institute of Psychiatry, King's College London, De Crespigny Park, London SE5 8AF, UK"},{"name":"Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London SE5 8AZ, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucia","family":"Gomez","sequence":"additional","affiliation":[{"name":"GKT School of Medical Education Department, King\u2019s College London University, London SE1 1UL, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Moore","sequence":"additional","affiliation":[{"name":"Department of Psychosis Studies, Institute of Psychiatry, Psychology &amp; Neuroscience, King\u2019s College London, London SE5 8AF, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fiona","family":"Gaughran","sequence":"additional","affiliation":[{"name":"Department of Psychosis Studies, Institute of Psychiatry, Psychology &amp; Neuroscience, King\u2019s College London, London SE5 8AF, UK"},{"name":"National Psychosis Unit, South London and Maudsley NHS Foundation Trust, London BR3 3BX, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Flanagan","sequence":"additional","affiliation":[{"name":"Toxicology Unit, Department of Clinical Biochemistry, King\u2019s College Hospital NHS Foundation Trust, Denmark Hill, London SE5 9RS, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"MacCabe","sequence":"additional","affiliation":[{"name":"Department of Psychosis Studies, Institute of Psychiatry, Psychology &amp; Neuroscience, King\u2019s College London, London SE5 8AF, UK"},{"name":"National Psychosis Unit, South London and Maudsley NHS Foundation Trust, London BR3 3BX, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Lally","sequence":"additional","affiliation":[{"name":"Department of Psychosis Studies, Institute of Psychiatry, Psychology &amp; Neuroscience, King\u2019s College London, London SE5 8AF, UK"},{"name":"National Psychosis Unit, South London and Maudsley NHS Foundation Trust, London BR3 3BX, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2016,6,2]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1185\/03007999709113338","article-title":"Treatment-resistant schizophrenia\u2014The role of clozapine","volume":"14","author":"Meltzer","year":"1997","journal-title":"Curr. 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