Clozapine - fatal constipation

Clozapine is an atypical antipsychotic that is effective for treatment-resistant schizophrenia. It causes agranulocytosis in up to 1% of patients¹ and regular monitoring of neutrophil counts is mandatory throughout treatment. In New Zealand one death from agranulocytosis has been reported to the IMMP. In contrast, four deaths from complications of severe constipation have been reported. This article reminds health professionals that the gastrointestinal (GI) effects of clozapine are potentially serious. Awareness of this issue may prevent life-threatening complications.