À propos d’un cas d’entérocolite nécrosante aiguë sous antipsychotiques

Nargeot, J.; Langlet, C; Merlot, Antoine; Buard, Mme; Mondoloni, A.; Viala, A; Vacheron, Marie-Noëlle

doi:10.2515/therapie/2013070

Cited by 2 publications

(4 citation statements)

References 17 publications

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“…Although several cases of constipation due to quetiapine have been reported,9 to the best of our knowledge, only one case of ischaemic colitis due to quetiapine has been published so far 5. In this case, quetiapine (150 mg) had been given for 9 months without noticeable side effects; however, because of worsening of symptoms, quetiapine was increased (to 600 mg), and cyamemazine (450 mg) and tropatepine (30 mg) were added.…”

Section: Discussionmentioning

confidence: 90%

“…An antipsychotic-induced ischaemic colon is a target for pathogenic bacterial organisms, leading to mucosa necrosis, and, in a context of septic shock, spontaneous outcome is towards death within 48–72 h 1 2 4 5 8. The literature shows that all antipsychotics do not have the same propensity to cause ischaemic colitis, and that, except for clozapine, colitis occurs more often in patients treated with several antipsychotics, with a relationship between the number of antipsychotics given and the severity of colitis 8.…”

Section: Discussionmentioning

confidence: 99%

“…The literature shows that all antipsychotics do not have the same propensity to cause ischaemic colitis, and that, except for clozapine, colitis occurs more often in patients treated with several antipsychotics, with a relationship between the number of antipsychotics given and the severity of colitis 8. The occurrence of ischaemic colitis also appears to be facilitated by concomitant absorption of anticholinergic drugs in antipsychotic-treated patients 1 4 5…”

Section: Discussionmentioning

confidence: 99%

“…The role of anticholinergic drugs has also been stressed 1 4. Only one case of ischaemic colitis involving quetiapine has been reported in the literature 5. However, in that case, quetiapine was co-prescribed with a phenothiazine, making it difficult to attribute responsibility to quetiapine alone in the occurrence of colitis.…”

Section: Introductionmentioning

confidence: 99%

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Colitis possibly induced by quetiapine

et al. 2015

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A 39-year-old man with bipolar disorder was hospitalised for depression. He was started on quetiapine (titrated up to 300 mg), lactulose (a laxative) and tropatepine (an anticholinergic). Valpromide (a mood stabiliser) and prazepam were later added and rapidly withdrawn. Seven days after quetiapine initiation, the patient reported abdominal pain and constipation; 2 days later, CT revealed an important distention of the colon including the caecum and a pre-perforation. A subtotal colectomy was performed and histology confirmed necrotising ischaemic colitis. The patient survived. This is the first case reported so far of ischaemic colitis related to quetiapine, in the absence of other antipsychotics simultaneously prescribed. Tropatepine likely acted as a cofactor to determine colitis. Clinicians need to be aware of the potential danger of the co-prescription of quetiapine with tropatepine (and possibly other anticholinergics).

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Section: Discussionmentioning

confidence: 90%