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Prevalence and Predictors of Clozapine-Associated Constipation: A Systematic Review and Meta-Analysis.


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.

SUBMITTER: Shirazi A 

PROVIDER: S-EPMC4926397 | biostudies-literature | 2016 Jun

REPOSITORIES: biostudies-literature

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Prevalence and Predictors of Clozapine-Associated Constipation: A Systematic Review and Meta-Analysis.

Shirazi Ayala A   Stubbs Brendon B   Gomez Lucia L   Moore Susan S   Gaughran Fiona F   Flanagan Robert J RJ   MacCabe James H JH   Lally John J  

International journal of molecular sciences 20160602 6


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  ...[more]

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