PDF(Pubmed)
Abstract：
The management of treatment-resistant schizophrenia (TRS) is challenging as the medications involved, often atypical antipsychotics, have a host of associated adverse effects. While complications such as agranulocytosis are well established and necessitate close hematological monitoring, the gastrointestinal effects of particular atypical antipsychotics, such as clozapine, are recognized to a lesser extent. The following case of TRS leading to chronic treatment-resistant pseudo-obstruction, eventually requiring total colectomy, highlights the considerable sequelae of clozapine on the gastrointestinal tract. Beyond the effects of severe constipation, the possible implications of ischemic colitis, stercoral perforation, and intraabdominal sepsis warrant a degree of caution when prescribing such medication. This study sheds light on the importance of monitoring bowel motility when administering antipsychotics, particularly clozapine, to avoid these deleterious consequences.
摘要：
治疗抗性精神分裂症（TRS）的管理具有挑战性，因为所涉及的药物，通常是非典型的抗精神病药，有一系列相关的不良影响。虽然粒细胞缺乏症等并发症已得到证实，需要密切的血液学监测，特定非典型抗精神病药的胃肠道作用，比如氯氮平,在较小程度上得到认可。以下TRS导致慢性治疗耐药假性梗阻的病例，最终需要全结肠切除术,突出显示氯氮平对胃肠道的相当大的后遗症。除了严重便秘的影响，缺血性结肠炎的可能含义，stercoral穿孔，和腹内败血症在开此类药物时需要一定程度的谨慎。这项研究揭示了在服用抗精神病药物时监测肠动力的重要性，尤其是氯氮平,避免这些有害后果。
