Constipation management in patients taking antipsychotics includes which approach?

• A. Increase fiber and fluids, increase exercise, and use lactulose or psyllium
• B. Decrease fiber and fluids
• C. Use laxatives only
• D. Avoid hydration

Answer: (A)

Constipation from antipsychotics happens because many of these drugs slow gut movement. The best management combines nonpharmacologic habits with appropriate laxatives to keep stools soft and easy to pass. Increasing dietary fiber and fluids, encouraging regular exercise, and using a bulk-forming agent like psyllium or an osmotic laxative like lactulose helps improve stool frequency and consistency. Psyllium adds bulk and moisture to the stool, promoting peristalsis, while lactulose draws water into the colon to soften stools and stimulate movement. These measures address the underlying slowed motility and stool hardness together, which is more effective than relying on laxatives alone or restricting fluids. Inadequate hydration or reducing fiber would worsen constipation, and avoiding hydration is clearly harmful. If symptoms persist despite these steps, further evaluation and tailored therapy should be considered.