Deadly drug sparks call for action

Study raises warning flag over dangers of antipsychotic medication’s side-effects

Kiwi researchers have called for urgent action over an antipsychotic drug linked to more than a dozen deaths in New Zealand. Clozapine, one of the main treatments for schizophrenia and sold under the brand Clozaril among others, works better than any other medication for about one-third of Rolling Stone Slate Royals Heroine Pure people, and is the “gold-standard” for treatment-resistant schizophrenia.

But a new study reveals some of its side effects are under-recognised, such as “slow gut”, which may lead to severe constipation, bowel obstruction, and even death.

Researchers from the University of Otago and Capital and Coast District Health Board analysed all the reported cases of serious clozapineinduced slow-gut submitted to New Zealand and Australian pharmacovigilance agencies over a 22-year period, making this the largest international study of these side effects.

“Official drug safety information in all countries under-estimated the prevalence of clozapine-induced slow gut almost 40-fold and provided almost no information about the range of effects this has,” said lead author Dr Susanna Every-Palmer, of the University of Otago’s Psychological Medicine Department.

The study, just published in the international journal CNS Drugs, uncovered 160 reports of serious clozapine-induced slow-gut.

At least 29 of these patients died — including 13 Kiwis. Serious slow-gut reactions affected clozapine users of all ages in this study, from a 17-yearold boy to 73-year-old man.

“We think serious harm . . . is preventable, but we definitely need more research to guide us,” Every-Palmer said. Researchers had not been paying much attention to the area.

Every-Palmer and co-author Professor Pete Ellis also compared the rate of serious clozapine-related gastrointestinal complications reported in this and other epidemiological studies with those in official drug safety sheets issued in NZ, Australia, Britain and the US. The results surprised and concerned them.

Earlier studies by the same team found clozapine slowed the gut in 80 per cent of users. Giving laxatives improved things significantly.

“While Medsafe has issued a number of prescriber updates on this issue, the manufacturers’ official drug safety datasheets are completely out of date,” Every-Palmer said.

“If prescribers and users don’t know about clozapine’s gut-related side effects, then they don’t know they need to prevent slow gut by using laxatives.

Ellis was worried that the message had not been getting across. “Despite a number of recent coroner’s cases . . . we are yet to see action.”