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Reflux oesophagitis and clozapine

M K Laker1, J C Cookson

  • 1Academic Unit of Human Psychopharmacology, Royal London and St Bartholomew's Hospital (NHS) Trust, St Clement's Hospital, UK.

International Clinical Psychopharmacology
|January 1, 1997
PubMed
Summary

Clozapine use in patients can lead to upper gastrointestinal symptoms like reflux esophagitis. Four out of thirty-six patients developed these issues within six weeks, with three showing erosive esophagitis on endoscopy.

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Area of Science:

  • Gastroenterology
  • Pharmacology
  • Clinical Medicine

Background:

  • Clozapine is an atypical antipsychotic used for treatment-resistant schizophrenia.
  • Gastrointestinal side effects are known but less commonly reported for upper GI issues.

Observation:

  • Four patients (11%) developed upper gastrointestinal symptoms within 6 weeks of initiating clozapine.
  • Symptoms were suggestive of reflux esophagitis.

Findings:

  • Endoscopic examination confirmed moderately severe erosive esophagitis in three patients.
  • Two of these patients had no prior history of upper gastrointestinal disorders.

Implications:

  • Clozapine may be associated with an increased risk of gastro-esophageal reflux and erosive esophagitis.

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  • Clinicians should consider monitoring for upper GI symptoms in patients starting clozapine therapy.