Clozapine-induced dysphagia with secondary substantial weight loss

Osman, Mugtaba; Devadas, Vekneswaran

doi:10.1136/bcr-2016-216445

Cited by 6 publications

(13 citation statements)

References 33 publications

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“…All were retained to give a wide range of data across different patient settings and psychiatric diagnoses. Only one paper quoted a patient's comments directly (Osman and Devadas, 2016) with four others quoting caregiver spoken or written comments (Guthrie et al, 2012, Guthrie et al, 2015, Guthrie and Stansfield, 2017, Hemsley et al, 2019.…”

Section: Quality Appraisalmentioning

confidence: 99%

“…In the case reports, some acknowledged ''self-report'' (Bhat et al, 2010, Chen et al, 2015, Crouse et al, 2017 but without further detail of the patient perspective. There was variation in the brief reporting of patient concerns, with the majority of descriptions reflecting patient complaints of swallowing difficulty (Bhat et al, 2010, Crouse et al, 2017, Duggal and Mendhekar, 2008, Dziewas et al, 2007, Lin et al, 2012, Nieves et al, 2007, Osman and Devadas, 2016, Varghese et al, 2006, or feeling unable to eat (Cicala et al, 2019, Lin et al, 2012. Other accounts suggested patient complaints of sialorrhea (Osman andDevadas, 2016, Sagar et al, 2005), and concerns regarding tremor (Leopold, 1996).…”

Section: Self Report Not Elaboratedmentioning

confidence: 99%

“…There was variation in the brief reporting of patient concerns, with the majority of descriptions reflecting patient complaints of swallowing difficulty (Bhat et al, 2010, Crouse et al, 2017, Duggal and Mendhekar, 2008, Dziewas et al, 2007, Lin et al, 2012, Nieves et al, 2007, Osman and Devadas, 2016, Varghese et al, 2006, or feeling unable to eat (Cicala et al, 2019, Lin et al, 2012. Other accounts suggested patient complaints of sialorrhea (Osman andDevadas, 2016, Sagar et al, 2005), and concerns regarding tremor (Leopold, 1996). Coughing was identified in several self-reports (Chen et al, 2015, Dziewas et al, 2007, Nieves et al, 2007, Tang and Hsieh, 2010.…”

Section: Self Report Not Elaboratedmentioning

confidence: 99%

“…One study captured a self-report of "difficulty chewing" (Leopold, 1996)p151. Other wider concerns raised by patients related to dysphagia included weight loss (Gregory et al, 1992, Osman and Devadas, 2016, Sico and Patwa, 2011, significant distress (Crouse et al, 2017, Mendhekar andAgarwal, 2010), regurgitation (Gregory et al, 1992), or difficulties swallowing medication (Cicala et al, 2019, Gregory et al, 1992, Guthrie et al, 2015, Hemsley et al, 2019.…”

Section: Self Report Not Elaboratedmentioning

confidence: 99%

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Mealtime difficulties in adults with mental health conditions: an integrative review

Guthrie

Baker

Cahill

et al. 2022

Journal of Mental Health

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Background: Dysphagia and choking are highly prevalent in adults with mental health conditions. However, there is scant research considering the personal experience of dysphagia for this population.Aims: to understand the evidence-base for strategies to involve the patient in recognition, assessment and treatment of mealtime difficulties Methods: this integrative review synthesised the literature on the experience of dysphagia in patients with mental health conditions. Patient consultation led to co-designed search terms and eligibility criteria for a systematic search of five scientific databases following Prisma guidance. Quality assessment of the eligible studies and reflexive thematic analysis were completed.Results: 31 studies were included for review. These included case reports, literature reviews and cross-sectional studies. Quality of evidence was weak and no intervention studies were identified. There was scant detail regarding the personal experience of dysphagia or choking.Themes identified related to biomedical perspectives, influencing factors presented without context, and decision-making led by clinicians.Conclusions: guidance on mental healthcare calls attention to under-diagnosis of physical co-morbidities and advocates patient inclusion. However, the patient voice in this population is rarely described regarding dysphagia. Further inclusive research is indicated to explore the impact of dysphagia and choking, and implications for interventions and outcome measures 2

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Section: Quality Appraisalmentioning

confidence: 99%

Section: Self Report Not Elaboratedmentioning

confidence: 99%

Section: Self Report Not Elaboratedmentioning

confidence: 99%

Section: Self Report Not Elaboratedmentioning

confidence: 99%

See 2 more Smart Citations

Mealtime difficulties in adults with mental health conditions: an integrative review

Guthrie

Baker

Cahill

et al. 2022

Journal of Mental Health

View full text Add to dashboard Cite

show abstract

“…Neurogenic dysphagia, a term loosely applied to cases where the pathology involves the central, autonomic or peripheral nervous system (and not isolated to the oesophagus such as achalasia) is more often characterised by an oropharyngeal component, with neurologists and speech pathologists primarily involved in management[ 64 , 65 ]. Dysphagia is common after cerebrovascular accidents (CVA) involving the cortex often causing hemiplegia[ 66 ].…”

Section: Aetiology and Pathogenesismentioning

confidence: 99%

Dysphagia: Thinking outside the box

Philpott

Garg

Tomic

et al. 2017

WJG

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Dysphagia is a common symptom that is important to recognise and appropriately manage, given that causes include life threatening oesophageal neoplasia, oropharyngeal dysfunction, the risk of aspiration, as well as chronic disabling gastroesophageal reflux (GORD). The predominant causes of dysphagia varies between cohorts depending on the interplay between genetic predisposition and environmental risk factors, and is changing with time. Currently in white Caucasian societies adopting a western lifestyle, obesity is common and thus associated gastroesophageal reflux disease is increasingly diagnosed. Similarly, food allergies are increasing in the west, and eosinophilic oesophagitis is increasingly found as a cause. Other regions where cigarette smoking is still prevalent, or where access to medical care and antisecretory agents such as proton pump inhibitors are less available, benign oesophageal peptic strictures, Barrett’s oesophagus, adeno- as well as squamous cell carcinoma are endemic. The evaluation should consider the severity of symptoms, as well as the pre-test probability of a given condition. In young white Caucasian males who are atopic or describe heartburn, eosinophilic esophagitis and gastroesophageal reflux disease will predominate and a proton pump inhibitor could be commenced prior to further investigation. Upper gastrointestinal endoscopy remains a valid first line investigation for patients with suspected oesophageal dysphagia. Barium swallow is particularly useful for oropharyngeal dysphagia, and oesophageal manometry mandatory to diagnose motility disorders.

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Swallowing Disorders in Schizophrenia

2017

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Disorders of swallowing are poorly characterized but quite common in schizophrenia. They are a source of considerable morbidity and mortality in this population, generally as a result of either acute asphyxia from airway obstruction or more insidious aspiration and pneumonia. The death rate from acute asphyxia may be as high as one hundred times that of the general population. Most swallowing disorders in schizophrenia seem to fall into one of two categories, changes in eating and swallowing due to the illness itself and changes related to psychotropic medications. Behavioral changes related to the illness are poorly understood and often involve eating too quickly or taking inappropriately large boluses of food. Iatrogenic problems are mostly related to drug-induced extrapyramidal side effects, including drug-induced parkinsonism, dystonia, and tardive dyskinesia, but may also include xerostomia, sialorrhea, and changes related to sedation. This paper will provide an overview of common swallowing problems encountered in patients with schizophrenia, their pathophysiology, and management. While there is a scarcity of quality evidence in the literature, a thorough history and examination will generally elucidate the predominant problem or problems, often leading to effective management strategies.

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Clozapine-induced dysphagia with secondary substantial weight loss

Cited by 6 publications

References 33 publications

Mealtime difficulties in adults with mental health conditions: an integrative review

Mealtime difficulties in adults with mental health conditions: an integrative review

Dysphagia: Thinking outside the box

Swallowing Disorders in Schizophrenia

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