Colonic architectural change on colonoscopy in patients taking psychotropic medications.
BACKGROUND
Patients on psychotropic medications have been clinically observed to have higher rates of abnormal colonic architecture resulting in difficult colonoscopies. This study aims to determine if a correlation between use of psychotropic medications and colonic architectural change seen on colonoscopy exists.


METHODS
A retrospective case-control study was undertaken with 252 adults selected from the hospital endoscopy database between January 2006 and July 2008. Cases were selected if they had 'capacious', 'megacolon', 'redundant' and/or 'featureless' colonic architecture reported in their first completed colonoscopy (n = 63). Demographic information and medication records were collected for both cases and controls. Logistic regression analysis was performed for each of the medication groups.


RESULTS
Medication groups associated with increased incidence for colonic architectural changes observed during colonoscopy include: antipsychotic medications [odds ratio (OR) 7.79, confidence interval (CI) 2.59-23.41], benzhexol (OR 23.50, CI 2.83-195.08) and iron tablets (OR 2.97, CI 1.39-6.33). Antidepressants, laxatives, benzodiazepines, gastroprotective medications and antihypertensive medications were not found to have any significant effect on changes to colonic architecture.


CONCLUSIONS
Use of antipsychotic medications is associated with changes to colonic architecture. This could predispose such a patient to difficult colonoscopy and therefore increase colonoscopy-associated risks. Medication history should be elicited prior to colonoscopy.
Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore. jet9199@gmail.com
Eu Jin
EJ
Tan
Keng Chuan
KC
Soh
Kee Yuan
KY
Ngiam
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000897:Anti-Ulcer Agents / Q000494:pharmacology; D000928:Antidepressive Agents / Q000494:pharmacology; D000959:Antihypertensive Agents / Q000494:pharmacology; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000494:pharmacology; D016022:Case-Control Studies; D003106:Colon / Q000187:drug effects* / Q000648:ultrastructure; D003113:Colonoscopy; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000494:pharmacology; D007501:Iron / Q000009:adverse effects / Q000494:pharmacology; D054368:Laxatives / Q000494:pharmacology; D008297:Male; D008531:Megacolon / Q000139:chemically induced; D008875:Middle Aged; D018727:Muscarinic Antagonists / Q000009:adverse effects / Q000494:pharmacology; D011619:Psychotropic Drugs / Q000009:adverse effects / Q000494:pharmacology*; D012189:Retrospective Studies; D014282:Trihexyphenidyl / Q000009:adverse effects / Q000494:pharmacology
D000897:Anti-Ulcer Agents; D000928:Antidepressive Agents; D000959:Antihypertensive Agents; D014150:Antipsychotic Agents; D006993:Hypnotics and Sedatives; D054368:Laxatives; D018727:Muscarinic Antagonists; D011619:Psychotropic Drugs; D014282:Trihexyphenidyl; D007501:Iron