Clinical hallmarks and peripheral immune factors associated with antipsychotic-induced constipation in schizophrenia.

BACKGROUND

Constipation is a frequent adverse effect of antipsychotic treatment in schizophrenia.

OBJECTIVES

This study aimed to investigate the prevalence and risk factors of antipsychotic-induced constipation (AIC) in patients with schizophrenia and examine associated alterations in peripheral immune factors.

METHODS

A total of 154 patients with schizophrenia were categorized into constipation and non-constipation groups based on the Rome IV constipation criteria. Clinical assessment included the Positive and Negative Syndrome Scale, Constipation Assessment Scale, and Bristol Stool Classification Scale. A subset of patients underwent secondary confirmation of constipation status using the Radiopaque Marker. Peripheral immune factors were analyzed using ProcartaPlex in 44 patients with constipation and 44 without.

DESIGN

This was a two-phase, cross-sectional observational study.

RESULTS

The prevalence of constipation was 36.36% (56/154). Among the 88 patients assessed for immune factors, serum IL-10 levels were nominally elevated in the constipation group compared to the non-constipation group (p = 0.043, Cohen's d = 0.32), an associated that did not remian statistically significant after false discovery rate correction (FDR-adjusted p = 0.432). In addition, the equivalent dose of clozapine showed a negative correlation with IL-1β levels. Logistic regression analysis showed a preliminary association of IL-10 with constipation.

CONCLUSION

The relatively high prevalence of AIC, particularly among clozapine users, highlights the need for increased clinical awareness and monitoring. The findings may suggest a possible link between AIC and inflammatory processes. Notably, a preliminary observation of elevated peripheral IL-10 levels in patients with constipation needs.

TRIAL REGISTRATION: Not applicable.