Clozapine and the Gastrointestinal Tract-View Presentation Slides

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The document provides a comprehensive overview of Clozapine and its significant impact on the gastrointestinal tract, specifically highlighting the condition known as Clozapine-Induced Gastrointestinal Hypomotility (CIGH). Presented by Susanna Every-Palmer of the University of Otago and organized by the American Psychiatric Association, the session aims to educate healthcare professionals on recognizing and managing the GI complications associated with this medication.<br /><br />Clozapine, while highly effective for treatment-resistant schizophrenia, can lead to severe GI issues, notably a "slow gut" that can cause bowel obstruction, ischemia, or even death. Key points include recognizing the five "S"s of CIGH: Slow gut, Significant commonness, Often silent, Serious risk, and the importance of Speeding up the gut through prophylactic laxatives upon starting Clozapine.<br /><br />The document recounts the tragic case of a woman named Kate, highlighting the need for awareness among both healthcare providers and patients regarding the side effects of clozapine. It underscores that constipation symptoms might not always be openly reported by patients, potentially due to embarrassment or lack of awareness, thus resulting in dangerous complications if not promptly addressed.<br /><br />The session recommends implementing a management protocol that includes educating staff, patients, and families, regularly monitoring GI function, and prioritizing quick medical intervention upon recognizing red flags like severe abdominal pain and distension. It emphasizes the necessity of using the lowest effective dose of Clozapine and avoiding lifestyle traps that blame patient habits instead of recognizing serious medication side effects.<br /><br />The discussion includes findings from studies, like the "Porirua Protocol", which demonstrate the effectiveness of integrating laxative regimens to decrease transit times and reduce the prevalence of severe GI complications. The overarching message is the critical need for preventive strategies and ongoing education to mitigate the risk of iatrogenic mortality from Clozapine treatment.

Keywords

Clozapine

Gastrointestinal Hypomotility

CIGH

American Psychiatric Association

treatment-resistant schizophrenia

prophylactic laxatives

Porirua Protocol

iatrogenic mortality

GI complications

preventive strategies