title: Fatalities associated with clozapine-related constipation and bowel obstruction: a literature review and two case reports.
abstract: BACKGROUND
  Constipation is an exceedingly common side effect of treatment with clozapine. In rare cases, this side effect has resulted in fatal complications.
  
  
  OBJECTIVE
  The authors review the literature on fatal complications of clozapine-related constipation and bowel obstruction.
  
  
  METHODS
  The authors provide two new case reports of patients who died of similar causes.
  
  
  RESULTS
  There were seven reports of deaths from clozapine-related bowel obstruction in the literature, with the most common mechanisms of death being severe impaction leading either to feculent vomiting or bowel necrosis.
  
  
  CONCLUSIONS
  The discussion outlines potential mechanisms and management of clozapine-related constipation.
authors.affiliation: correspondence and M.D., 4333 Chemin de la Cote Ste-Catherine, Montreal, Quebec H3T 1E4. katharine.hibbard@mail.mcgill.ca
authors.forename: Katharine R
authors.initials: KR
authors.lastname: Hibbard
authors.forename: Arthur
authors.initials: A
authors.lastname: Propst
authors.forename: Daniel E
authors.initials: DE
authors.lastname: Frank
authors.forename: Jonathan
authors.initials: J
authors.lastname: Wyse
mesh_terms: D000927:Anticonvulsants / Q000008:administration & dosage; D014150:Antipsychotic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D003024:Clozapine / Q000008:administration & dosage / Q000009:adverse effects*; D003248:Constipation / Q000139:chemically induced* / Q000401:mortality*; D004359:Drug Therapy, Combination; D005479:Flurazepam / Q000008:administration & dosage; D018757:GABA Modulators / Q000008:administration & dosage / Q000009:adverse effects; D005905:Glyburide / Q000008:administration & dosage; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage; D007415:Intestinal Obstruction / Q000139:chemically induced* / Q000401:mortality*; D007441:Intubation, Gastrointestinal / Q000009:adverse effects; D000077213:Lamotrigine; D008297:Male; D008333:Mandelic Acids / Q000008:administration & dosage; D008875:Middle Aged; D018727:Muscarinic Antagonists / Q000008:administration & dosage; D011352:Procyclidine / Q000008:administration & dosage; D012559:Schizophrenia / Q000188:drug therapy*; D013974:Thyroxine / Q000008:administration & dosage; D014227:Triazines / Q000008:administration & dosage
chemical_list: D000927:Anticonvulsants; D014150:Antipsychotic Agents; D018757:GABA Modulators; D007004:Hypoglycemic Agents; D008333:Mandelic Acids; D018727:Muscarinic Antagonists; D014227:Triazines; D011352:Procyclidine; D005479:Flurazepam; D003024:Clozapine; C005419:oxybutynin; D013974:Thyroxine; D005905:Glyburide; D000077213:Lamotrigine