Background

• Clozapine has uniquely complex binding properties allowing it to bind to a variety of receptors including histamine, muscarinic, dopaminergic, and serotonergic receptors which contribute to its diverse side effect profile.
• Recommendations for routine evaluation and management of rare but serious side effects have been developed for: agranulocytosis (frequency <1%), myocarditis (frequency <1%), and seizures (frequency ~3).
• Constipation is reported in 14%-25% of patients taking clozapine; however, no standard protocol for routine evaluation has been developed.

The purpose of this study is to evaluate the impact of a clozapine-induced constipation monitoring protocol at Fulton State Hospital, along-term forensic psychiatric setting.

• To determine if the implementation of a clozapine-induced constipation monitoring protocol affects:
  • Number of constipation related referrals made to an external academic medical facility
  • Number of referrals to Fulton State Hospital’s internal medical clinics

• Establish a correlation between anticholinergic burden and severity of constipation
• Survey employee understanding and reception of a clozapine-induced constipation monitoring protocol

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