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International Clinical Psychopharmacology:
doi: 10.1097/YIC.0b013e32835b08d2
Original Articles

In a randomized placebo-controlled add-on study orlistat significantly reduced clozapine-induced constipation

Chukhin, Evgenya; Takala, Pirjob; Hakko, Helinäc; Raidma, Mirjamd; Putkonen, Hannab,e; Räsänen, Pirkkof; Terevnikov, Viacheslavd; Stenberg, Jan-Henrya; Eronen, Markkub; Joffe, Grigoria

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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.

© 2013 Lippincott Williams & Wilkins, Inc.

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