Neuroleptics: Warning on Severe Digestive Complications
The French National Agency for the Safety of Medicines and Health Products (ANSM) has issued an alert regarding severe and potentially fatal digestive complications linked to the use of neuroleptics. According to the agency, grave cases continue to be reported, prompting a call for increased caution among patients and healthcare providers.
Neuroleptics, also known as antipsychotics, are used to treat schizophrenia, bipolar disorders, agitation, resistant depression, and neurological diseases like Alzheimer’s. In France, the ANSM reports that approximately 0.8% of the population aged 11 to 75 receives these treatments.
Why is the use of neuroleptics increasing?
Consumption of these medications is on the rise. Data presented at the 2025 RESPADD (addiction prevention network) congress showed a 48.5% increase in use among adolescents between 2014 and 2021.
These drugs require mandatory medical prescriptions and rigorous clinical monitoring. However, the Haute Autorité de Santé (HAS) states that one-third of analyzed adverse drug events result from a failure to evaluate the treatment or its digestive side effects.
How do these medications affect intestinal transit?
These substances create an anticholinergic effect that significantly slows intestinal muscle contractions. The Observatoire des Médicaments, des Dispositifs médicaux et de l’Innovation Thérapeutique (OMéDIT) explains that this mechanism greatly increases the risk of severe constipation.
Risks intensify when a patient experiences an “anticholinergic load.” This occurs when neuroleptics are combined with other medications, such as antispasmodics, antiparkinsonians, or antidepressants.
What are the emergency warning signs of intestinal occlusion?
Slowed transit can evolve into absolute emergencies, including peritonitis, intestinal perforation, functional intestinal occlusion, or the formation of a fecaloma. The French National Society of Gastroenterology warns that patients should look for fever, vomiting, a distended abdomen, intense abdominal pain, or a total absence of stools.
The ANSM specifically warns against “overflow diarrhea.” This occurs when unexplained soft stools mask a severe blockage, allowing only liquid waste to pass through the obstructed intestine.
How can patients prevent digestive complications?
Prevention requires hygiene-dietary measures, including regular physical activity, maintaining hydration, and eating a fiber-rich diet. Doctors should monitor a patient’s abdominal perimeter, weight, and stool frequency during every consultation.
The HAS highlights that patients over 60 and those with schizophrenia are at higher risk. Some psychiatric patients may be less sensitive to physical pain, which could mask an intestinal occlusion until it reaches an advanced stage.
Patients are warned never to stop their treatment without consulting a specialist, even if they experience constipation.
Frequently Asked Questions
Which medication combinations increase the risk of digestive issues?
According to the source, the risk increases when neuroleptics are combined with antidepressants, antispasmodics, or antiparkinsonians, creating an anticholinergic load.
What is “overflow diarrhea” in the context of neuroleptics?
The ANSM describes this as a situation where soft stools mask a severe intestinal blockage, as only the liquid portion of the waste can pass through the obstructed area.
Can a patient stop taking neuroleptics if they develop severe constipation?
No. The guidance states that patients must never stop their treatment without first speaking to their specialist.
Do you discuss digestive health and stool frequency with your doctor during routine medication check-ups?