title: In a randomized placebo-controlled add-on study orlistat significantly reduced clozapine-induced constipation.
abstract: Constipation is a common and potentially fatal side effect of clozapine treatment. Another important side effect of clozapine may also be significant weight gain. Orlistat is a weight-control medication that is known to induce loose stools as a common side effect. This study aimed to explore whether orlistat used to control clozapine-induced weight gain can simultaneously tackle clozapine-related constipation. In this 16-week randomized-controlled study, clozapine-treated patients received add-on orlistat (n=30) or add-on placebo (n=24). Colonic function was measured using the Bristol Stool Form Scale. There was a significant (P=0.039) difference in the prevalence of constipation in favor of orlistat over placebo in completers (n=40) at the endpoint. A decrease in the prevalence of constipation within the orlistat group (P=0.035) was observed (vs. no statistically significant changes in the placebo group). In clozapine-treated patients, orlistat may be beneficial not only for weight control but also as a laxative. As no established treatments for clozapine-induced constipation exist, orlistat can be considered for this population, although more studies are required.
authors.affiliation: Department of Psychiatry, Helsinki University Central Hospital, Helsinki, Finland. evgeny.chukhin@hus.fi
authors.forename: Evgeny
authors.initials: E
authors.lastname: Chukhin
authors.forename: Pirjo
authors.initials: P
authors.lastname: Takala
authors.forename: Helinä
authors.initials: H
authors.lastname: Hakko
authors.forename: Mirjam
authors.initials: M
authors.lastname: Raidma
authors.forename: Hanna
authors.initials: H
authors.lastname: Putkonen
authors.forename: Pirkko
authors.initials: P
authors.lastname: Räsänen
authors.forename: Viacheslav
authors.initials: V
authors.lastname: Terevnikov
authors.forename: Jan-Henry
authors.initials: JH
authors.lastname: Stenberg
authors.forename: Markku
authors.initials: M
authors.lastname: Eronen
authors.forename: Grigori
authors.initials: G
authors.lastname: Joffe
mesh_terms: D019440:Anti-Obesity Agents / Q000009:adverse effects / Q000627:therapeutic use*; D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001569:Benzodiazepines / Q000009:adverse effects / Q000627:therapeutic use; D003024:Clozapine / Q000009:adverse effects* / Q000627:therapeutic use; D003106:Colon / Q000187:drug effects / Q000503:physiopathology; D003248:Constipation / Q000139:chemically induced / Q000503:physiopathology / Q000517:prevention & control*; D003430:Cross-Sectional Studies; D003967:Diarrhea / Q000139:chemically induced; D004311:Double-Blind Method; D005387:Finland / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007783:Lactones / Q000009:adverse effects / Q000627:therapeutic use*; D054368:Laxatives / Q000009:adverse effects / Q000627:therapeutic use; D009765:Obesity / Q000188:drug therapy* / Q000523:psychology; D000077152:Olanzapine; D000077403:Orlistat; D050177:Overweight / Q000188:drug therapy* / Q000523:psychology; D010352:Patient Dropouts; D015995:Prevalence; D011618:Psychotic Disorders / Q000150:complications / Q000188:drug therapy; D012559:Schizophrenia / Q000150:complications / Q000188:drug therapy; D012720:Severity of Illness Index; D015431:Weight Loss / Q000187:drug effects
chemical_list: D019440:Anti-Obesity Agents; D014150:Antipsychotic Agents; D007783:Lactones; D054368:Laxatives; D001569:Benzodiazepines; D000077403:Orlistat; D003024:Clozapine; D000077152:Olanzapine