Minimizing antipsychotic medication obviated the need for enema against severe constipation leading to paralytic ileus: A case report

T. Suzuki, H. Uchida, K. Watanabe, H. Kashima

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Objective: To report the usefulness of antipsychotic dose-reduction for avoiding paralytic ileus in a patient with chronic schizophrenia and comorbid dementia. Case summary: A 65-year-old in-patient developed severe paralytic ileus warranting a transfer to the general hospital. Constipation was very troublesome and he often needed enema to prevent intestinal obstruction. He had originally been treated with 24 mg of bromperidol, which was reduced to 4 mg, and other psychotropic treatments were simultaneously simplified. As a result, bowel habits improved and enema is now only rarely necessary. Constipation is a frequent adverse effect of antipsychotics and adjunctive psychotropics, which can be severe and may lead to life-threatening paralytic ileus. Dose-reduction obviated a necessity of enema against persistent constipation, while the patient's mental status remained under control. Assessment using the Naranjo probability scale revealed a definite causal relationship. Discussion: With an increasing number of elderly patients with schizophrenia, more cases of severe gastrointestinal motility problems from antipsychotic medication are to be expected. In this patient population dose-reduction of antipsychotics and simplification of concomitant psychotropics should be seriously considered.

Original languageEnglish
Pages (from-to)525-527
Number of pages3
JournalJournal of Clinical Pharmacy and Therapeutics
Volume32
Issue number5
DOIs
Publication statusPublished - 2007 Oct 1

Keywords

  • Antipsychotic
  • Dementia
  • Dose reduction
  • Enema
  • Paralytic ileus
  • Schizophrenia

ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)

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