Potential risk analysis of antipsychotics-related constipation from the FDA Adverse Event Reporting System

Antipsychotics-related constipation is a frequently neglected and poorly researched adverse effects in patients in clinical practice. Constipation not only affects the physical health of patients but also increases the psychological stress to their disease burden, so it requires more attention.

We queried adverse event reports of antipsychotics-related constipation from the FDA Adverse Event Reporting System (FAERS) database between January 2017 and December 2022. The report odds ratio (ROR) and 95% confidence intervals (CIs) were calculated using case/non-case methods.

A total of 562 constipation cases were attributed to atypical antipsychotics (AAPs) during the study period. Except for aripiprazole and ziprasidone, the p values of the other drugs were all less than 0.05. The RORs values in descending order: amisulpride (ROR = 4.07), paliperidone (ROR = 2.73), quetiapine (ROR = 1.83), clozapine (ROR = 1.61), olanzapine (ROR = 1.50), risperidone (ROR = 0.71).

This study found that clozapine, olanzapine, amisulpride, quetiapine, and paliperidone were correlated with constipation, while risperidone had the least effect on gastrointestinal function. Future analysis of the FAERS database in conjunction with other data sources will be essential for continuous monitoring of antipsychotics-related constipation.