The National Medicines Safety Agency (ANSM) calls on doctors and caregivers to prevent the risk of constipation, sometimes severe, associated with taking neuroleptics. She emphasizes the importance of appropriate prevention, increased vigilance and early management of any constipation.
Constipation linked to taking neuroleptics can sometimes be severe, due to their anticholinergic properties. Known, common adverse effect, it is listed in the instructions and summaries of the product characteristics of these medicines. Constipation can in some cases be responsible for serious complications or even death.
In consultation with representatives of psychiatrists, the ANSM recommends that doctors be particularly vigilant:
- To drug combinations with the prescribed neuroleptic, in order to avoid an accumulation of drugs with anticholinergic effects;
- Transit and digestive functions of patientss, with early detection of warning signs (abdominal pain, severe constipation, unexplained diarrhea);
- Rapid initiation of appropriate treatment in cases of acute colonic atony (stopping antipsychotics if necessary, evacuating a fecal impaction, surgical treatment if necessary);
- For patients aged 60 and more who may also be particularly sensitive to anticholinergic effects.
What to do:
- Assess the anticholinergic burden of the prescription (for example using the Omedit calculator. Note that only the anticholinergic impregnation coefficient (CIA) scale provides an exhaustive view of medications with anticholinergic effects available in France;
- Install preventive treatment appropriate from the start of the neuroleptic if there are risk factors for constipation in the patient;
- Advise you to adopt hygienic and dietary measures : sufficient hydration, diet rich in fiber, appropriate physical activity (when possible);
- Teach the patient and those around him to recognize the signs that should alert (abdominal pain, severe constipation, etc.) and the importance of consulting quickly;
- Ask the patient regularly about its transit, even in the absence of complaint.
Neuroleptics and constipation: vigilance essential to limit the risk of complications, ANSM, June 11, 2026