The aim of this work is to review the association between ileus and some of the most commonly used psychotropic drugs.
Many drugs commonly used in psychiatry, including antipsychotics, may cause various gastrointestinal side effects. Very often these are mild to moderate and easily managed. However, more serious situations can occur leading, in extremis, to severe intestinal hypomotility and dilatation. 
Materials and Methods: A search using the terms “ileus” and “psychotropic drugs” was conducted in Pubmed database. Articles were selected according to their relevance. Psychopharmacology books were also included in the bibliographic search. 
Results and Conclusions: We report the case of a 39 year old woman with Bipolar Disorder who was admitted to the psychiatric ward during a maniac episode and medicated with several drugs including an antipsychotic, mood stabilizers and an anticholinergic. On the fifth day after admission she showed symptomatic hypotension, vomiting and a generalised tonic-clonic seizure. She was transfered to the Emergency Room and a thoracoabdominal CT-scan showed an almost totally dilated ileus and colon. She was submitted to an exploratory laparotomy in order to reduce the intrabdominal pressure. Given the high probability of iatrogeny, all psychotropic drugs were withdrawn. During two weeks in intensive care she gradually recovered, psychotropic drugs were carefully reintroduced before the hospital discharge. 
Patients medicated with psychotropic drugs should be regularly questioned about constipation and submitted to physical examination. Gastrointestinal symptoms should be treated carefully in these patients in order to prevent more serious complications.

ILEUS AND PSYCHOTROPIC DRUGS - A NEARLY FATAL CASE