Clozapine-induced gastrointestinal hypomotility (CIGH)
- Prevention is better than rescue
- Monitor bowel function from clozapine start
- Prefer osmotic + stimulant laxative regimen
- PEG + senna/bisacodyl are common
- Avoid bulk-forming fiber in true hypomotility
- No stool + pain/distention/vomiting = emergency
- Reduce other antimuscarinic burden
Use at a glance
- Prevention is better than rescue
Practical pearls
- Prefer osmotic + stimulant laxative regimen
- PEG + senna/bisacodyl are common
Other practical pearls
- No stool + pain/distention/vomiting = emergency
- Reduce other antimuscarinic burden
Monitoring / follow-up
- Monitor bowel function from clozapine start
- Avoid bulk-forming fiber in true hypomotility
Self-check
- What signals an emergency in clozapine GI hypomotility?
No stool plus pain, distention or vomiting. - Which fiber should be avoided in true GI hypomotility?
Bulk-forming fiber.
Drugs used for this (4)
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