The relation between second-generation antipsychotics and laxative use in elderly patients with schizophrenia

Area of Science:

• Geriatric Psychiatry
• Pharmacology
• Gastroenterology

Background:

• Elderly patients with schizophrenia often experience constipation.
• Second-generation antipsychotics (SGAs) are commonly prescribed for schizophrenia.
• Concomitant laxative use in this population requires investigation.

Purpose of the Study:

• To identify factors associated with laxative use in elderly schizophrenia patients on SGAs.
• To analyze trends in laxative use over time.

Main Methods:

• Retrospective analysis of 1727 elderly schizophrenia patients discharged between 2006-2019.
• Multivariate logistic regression to determine factors associated with laxative use.
• Cochrane-Armitage trend test for temporal analysis.

Main Results:

• 42.4% of patients used concomitant laxatives.
• Female gender, mood stabilizer use, and diabetes mellitus were associated with increased laxative use.
• Clozapine showed the highest laxative use rate; rates increased from 30.8% to 46.6% over the study period.

Conclusions:

• Laxative use is prevalent in elderly schizophrenia patients on SGAs.
• Consider switching to SGAs with lower constipation risk or discontinuing mood stabilizers if feasible.
• Further research into optimizing gastrointestinal care for this population is warranted.