Lessons Learned at the Interface of Medicine and Psychiatry
The Psychiatric Consultation Service at Massachusetts General Hospital sees medical and surgical inpatients with comorbid psychiatric symptoms and conditions. During their twice-weekly rounds, Dr Stern and other members of the Consultation Service discuss diagnosis and management of hospitalized patients with complex medical or surgical problems who also demonstrate psychiatric symptoms or conditions. These discussions have given rise to rounds reports that will prove useful for clinicians practicing at the interface of medicine and psychiatry.
Prim Care Companion CNS Disord 2025;27(4):25f03984
Author affiliations are listed at the end of this article.
Free Access: Please Log In
This content is completely free—but you need to be logged in to read the full article. If you already have an account, please log in below. Otherwise, register for free to unlock instant access.
References (28)
- Hippius H. A historical perspective of clozapine. J Clin Psychiatry. 1999;60(suppl 12):22–23. PubMed
- Nucifora FC Jr, Mihaljevic M, Lee BJ, et al. Clozapine as a model for antipsychotic development. Neurotherapeutics. 2017;14(3):750–761. PubMed CrossRef
- Kane J, Honigfeld G, Singer J, et al. Clozapine for the treatment-resistant schizophrenic: a double-blind comparison with chlorpromazine. Arch Gen Psychiatry. 1988;45(9):789–796. PubMed CrossRef
- McEvoy JP, Lieberman JA, Stroup TS, et al. Effectiveness of clozapine versus olanzapine, quetiapine, and risperidone in patients with chronic schizophrenia who did not respond to prior atypical antipsychotic treatment. Am J Psychiatry. 2006;163(4):600–610. PubMed CrossRef
- Lewis SW, Barnes TRE, Davies L, et al. Randomized controlled trial of effect of prescription of clozapine versus other second-generation antipsychotic drugs in resistant schizophrenia (CUtLASS 2). Schizophr Bull. 2006;32(4):715–723. PubMed CrossRef
- Khokhar JY, Henricks AM, Sullivan ED, et al. Unique effects of clozapine: a pharmacological perspective. Adv Pharmacol. 2018;82:137–162. PubMed CrossRef
- Schatzberg AF, DeBattista C. Antipsychotic drugs. In: Cole JO, DeBattista C, Schatzberg F, eds. Manual of Clinical Psychopharmacology. 8th ed. American Psychiatric Publishing; 2015:223–233.
- Howes OD, McCutcheon R, Agid O, et al. Treatment-resistant schizophrenia: treatment response and resistance in psychosis (TRRIP) working group consensus guidelines on diagnosis and terminology. Am J Psychiatry. 2017;174(3):216–229. PubMed CrossRef
- Seeman P. Clozapine, a fast-off-D2 antipsychotic. ACS Chem Neurosci. 2014;5(1): 24–29. PubMed CrossRef
- Mijovic A, MacCabe JH. Clozapine-induced agranulocytosis. Ann Hematol. 2020;99(11):2477–2482. PubMed CrossRef
- Kilian JG, Kerr K, Lawrence C, et al. Myocarditis and cardiomyopathy associated with clozapine. Lancet. 1999;354(9193):1841–1845. PubMed CrossRef
- Williams AM, Park SH. Seizure associated with clozapine: incidence, etiology, and management. CNS Drugs. 2015;29(2):101–111. PubMed CrossRef
- Sachdev P, Kruk J, Kneebone M, et al. Clozapine-induced neuroleptic malignant syndrome: review and report of new cases. J Clin Psychopharmacol. 1995;15(5):365–371. PubMed CrossRef
- Berman BD. Neuroleptic malignant syndrome: a review for neuro-hospitalists. Neurohospitalist. 2011;1(1):41–47. PubMed CrossRef
- West S, Rowbotham D, Xiong G, et al. Clozapine induced gastrointestinal hypomotility: a potentially life-threatening adverse event. A review of the literature. Gen Hosp Psychiatry. 2017;46:32–37. PubMed CrossRef
- Every-Palmer S, Ellis PM. Clozapine-induced gastrointestinal hypomotility: a 22- year bi-national pharmacovigilance study of serious or fatal ‘slow gut’ reactions, and comparison with international drug safety advice. CNS Drugs. 2017;31(8):699–709. PubMed CrossRef
- De Hert M, Correll CU, Bobes J, et al. Physical illness in patients with severe mental disorders. I. Prevalence, impact of medications and disparities in health care. World Psychiatry. 2011;10(1):52–77. PubMed CrossRef
- Shirazi A, Stubbs B, Gomez L, et al. Prevalence and predictors of clozapine- associated constipation: a systematic review and meta-analysis. Int J Mol Sci. 2016;17(6):863. PubMed CrossRef
- Nielsen J, Damkier P, Lublin H, et al. Optimizing clozapine treatment. Acta Psychiatr Scand. 2011;123(6):411–422. PubMed CrossRef
- Blackman G, Oloyede E, Horowitz M, et al. Reducing the risk of withdrawal symptoms and relapse following clozapine discontinuation—is it feasible to develop evidence-based guidelines? Schizophr Bull. 2022;48(1):176–189. PubMed CrossRef
- Bickerton L, Kuriakose JL. Management of cholinergic rebound after abrupt withdrawal of clozapine: a case report and systematic literature review. JACLP. 2024;65(1):76–88. PubMed CrossRef
- Edinoff AN, Sauce E, Ochoa CO, et al. Clozapine and constipation: a review of clinical considerations and treatment options. Psychiatry Int. 2021;2(3):344–352. CrossRef
- Every-Palmer S, Ellis PM, Nowitz M, et al. The Porirua protocol in the treatment of clozapine-induced gastrointestinal hypomotility and constipation: a pre-and post- treatment study. CNS Drugs. 2017;31(1):75–85. PubMed CrossRef
- Poetter CE, Stewart JT. Treatment of clozapine-induced constipation with bethanechol. J Clin Psychopharmacol. 2013;33(5):713–714. PubMed CrossRef
- Attard A, Iles A, Attard S, et al. Clozapine: why wait to start a laxative? Br J Psych Adv. 2019;25(6):377–386. CrossRef
- Cruz A, Freudenreich O. Clozapine-induced GI hypomotility: from constipation to bowel obstruction. Curr Psychiatry. 2018;17(8):44–45.
- Torrico TJ, Kaur S, Dayal M, et al. Lubiprostone for the treatment of clozapine-induced constipation: a case series. Cureus. 2022;14(6):e25576. PubMed CrossRef
- Tomulescu S, Uittenhove K, Boukakiou R. Managing recurrent clozapine-induced constipation in a patient with resistant schizophrenia. Case Rep Psychiatry. 2021;2021(1):9649334. PubMed CrossRef
Buy PDF for $40
Please sign in or purchase this PDF for $40.
Save
Share
Cite
