Clinical hallmarks and peripheral immune factors associated with antipsychotic-induced constipation in schizophrenia

Background: Constipation is a frequent adverse effect of antipsychotic treatment in schizophrenia. Objectives: This study aimed to investigate the prevalence and risk factors of antipsychotic-induced constipation (AIC) in patients with schizophrenia and examine associated alterations in peripheral immune factors. Methods: A total of 154 patients with schizophrenia were categorized into constipation and non-constipation groups based on the Rome IV constipation criteria. Clinical assessment included the Positive and Negative Syndrome Scale, Constipation Assessment Scale, and Bristol Stool Classification Scale. A subset of patients underwent secondary confirmation of constipation status using the Radiopaque Marker. Peripheral immune factors were analyzed using ProcartaPlex in 44 patients with constipation and 44 without. Design: This was a two-phase, cross-sectional observational study. Results: The prevalence of constipation was 36.36% (56/154). Among the 88 patients assessed for immune factors, serum IL-10 levels were nominally elevated in the constipation group compared to the non-constipation group ( p = 0.043, Cohen’s d = 0.32), an associated that did not remian statistically significant after false discovery rate correction (FDR-adjusted p = 0.432). In addition, the equivalent dose of clozapine showed a negative correlation with IL-1β levels. Logistic regression analysis showed a preliminary association of IL-10 with constipation. Conclusion: The relatively high prevalence of AIC, particularly among clozapine users, highlights the need for increased clinical awareness and monitoring. The findings may suggest a possible link between AIC and inflammatory processes. Notably, a preliminary observation of elevated peripheral IL-10 levels in patients with constipation needs. Trial registration: Not applicable.