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Evidence summaries

Pharmacological Treatment for Antipsychotic-Related Constipation

There is insufficient evidence to assess the effectiveness and safety of pharmacological interventions for treating antipsychotic-related constipation. Level of evidence: "D"

The quality of evidence is downgraded by study quality and imprecise data.

Summary

A Cochrane review [Abstract] 1 included 2 studies with a total of 480 subjects. Studies searched for were all published and unpublished randomised controlled trials (RCTs) investigating the efficacy of pharmacological treatments in patients with antipsychotic-related constipation.

One study compared glycerol suppository with the traditional Chinese medicine (TCM) approaches of tuina massage and acupuncture. Compared to tuina massage, glycerol laxative was less effective in relieving constipation at both two days after treatment (1 RCT; N = 120; RR 2.88, 95% CI 1.89 to 4.39), and three days (1 RCT; N = 120; RR 4.80, CI 1.96 to 11.74). Favourable results were also seen for acupuncture at two days (1 RCT; N = 120; RR 3.50; 95% CI 2.18 to 5.62), and at three days (1 RCT; N = 120; RR 8.00, 95% CI 2.54 to 25.16).The other study compared mannitol, an osmotic laxative, with rhubarb soda or phenolphthalein. Mannitol was more effective than rhubarb soda or phenolphthalein in trelieving constipation within 24 hours of treatment (1 RCT; N = 240; RR 0.07; 95% CI 0.02 to 0.27).No data were reported for our other important outcomes: need for rescue medication, bowel obstruction (a complication of antipsychotic-related constipation), quality of life, adverse events, leaving the study early, and economic costs.

Clinical comments

Note

Date of latest search:

References

  • Every-Palmer S, Newton-Howes G, Clarke MJ. Pharmacological treatment for antipsychotic-related constipation. Cochrane Database Syst Rev 2017;(1):CD011128. [PubMed]

Primary/Secondary Keywords