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Clozapine-induced hypersalivation.

L Davydov¹, S R Botts

¹College of Pharmacy and Allied Health Professions, St. John's University, Jamaica, NY, USA.

The Annals of Pharmacotherapy

|June 14, 2000

Summary

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Clozapine-induced hypersalivation affects up to 54% of patients. Management strategies include dose reduction, chewing gum, or medications like anticholinergics.

Area of Science:

Pharmacology
Neuroscience

Background:

Clozapine is an atypical antipsychotic used for treatment-resistant schizophrenia.
Hypersalivation (sialorrhea) is a common and distressing side effect of clozapine therapy.

Purpose of the Study:

To review the pathophysiology of clozapine-induced hypersalivation.
To explore potential treatment options for this adverse effect.

Main Methods:

A literature search was conducted using MEDLINE from 1966 to May 1999.
Keywords included clozapine, hypersalivation, sialorrhea, and treatment.

Main Results:

Hypersalivation affects a significant portion of patients, occurring in up to 54%.
Studies and case reports on managing clozapine-induced hypersalivation were evaluated.

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Conclusions:

The exact mechanism of clozapine-induced hypersalivation remains unclear, with potential roles for muscarinic M4 receptor activation or alpha2-adrenoceptor blockade.
Possible etiological factors include altered swallowing reflexes.
Treatment options encompass behavioral interventions (gum chewing), dose adjustment, and pharmacotherapy (anticholinergics, alpha2-adrenoceptor agonists).