Clozapine-induced constipation: a service evaluation
Intended for healthcare professionals
Evidence and practice    

Clozapine-induced constipation: a service evaluation

Yie Lee Medical student, Cardiff University, Cardiff, Wales
Catherine Ford Clozapine clinic coordinator, Cardiff and Vale University Health Board, Cardiff, Wales
John Tredget Community mental health nurse, Pendine community mental health team, Cardiff and Vale University Health Board and research nurse, National Centre for Mental Health, Cardiff University, Cardiff, Wales

Background Clozapine is an atypical antipsychotic drug successfully used in the treatment of psychotic disorders. However, it is associated with life-threatening conditions including constipation and there is evidence to show that death from constipation may now exceed death from agranulocytosis.

Aim To discover the rate of constipation among clozapine-treated patients and to raise awareness of the need for thorough assessment and treatment of these patients.

Method At routine clinic appointments, 155 patients were asked about their bowel habit and use of laxatives using a nine-question structured interview form. Visual prompts were used including the Bristol stool chart and pictures of packaging from laxative products. Constipation was identified using the Rome III criteria.

Results Forty three per cent of the sample scored positively for constipation. Patients who took laxatives were between two and four times more likely to have constipation than those who did not take laxatives.

Conclusion All nursing staff need to be aware of the dangers associated with clozapine-induced constipation and that prescription of laxatives does not preclude patients being constipated.

Mental Health Practice. doi: 10.7748/mhp.2019.e1447

Peer review

This article has been subject to external double-blind peer review and has been checked for plagiarism using automated software


Conflict of interest

None declared

Lee Y, Ford C, Tredget J (2019) Clozapine-induced constipation: a service evaluation. Mental Health Practice. doi: 10.7748/mhp.2019.e1447


The authors would like to thank College Data Clinics, Cardiff University, for guiding the authors through statistics. Ben Ussher, nursing student, Cardiff University, for his help in the pilot part of this study

Published online: 17 October 2019

Want to read more?

Already subscribed? Log in


Unlock full access to RCNi Plus today

Save over 50% on your first 3 months

Your subscription package includes:
  • Unlimited online access to all 10 RCNi Journals and their archives
  • Customisable dashboard featuring 200+ topics
  • RCNi Learning featuring 180+ RCN accredited learning modules
  • RCNi Portfolio to build evidence for revalidation
  • Personalised newsletters tailored to your interests
RCN student member? Try Nursing Standard Student

Alternatively, you can purchase access to this article for the next seven days. Buy now