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Hypersalivation induced by olanzapine with fluvoxamine
Takafumi Hori1, Kenichi Makabe, Kiyotaka Nemoto
1Department of Psychiatry, Institute of Clinical Medicine, Graduate School of Comprehensive Human Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba 305-8575, Japan. takahori@md.tsukuba.ac.jp
Summary
Hypersalivation, a rare side effect of atypical antipsychotics like olanzapine, occurred paradoxically. This case highlights potential risks when combining olanzapine with selective serotonin reuptake inhibitors (SSRIs).
Area of Science:
- Psychiatry
- Pharmacology
Background:
- Atypical antipsychotics, including clozapine and olanzapine, are known to cause dry mouth due to anticholinergic effects.
- Hypersalivation is a less common, paradoxical adverse effect associated with these medications.
Observation:
- A 34-year-old Japanese man with delusional disorder, somatic type, experienced chronic neck pain and somatic hallucinations.
- Olanzapine (10 mg/day) was added to his existing fluvoxamine (200 mg/day) treatment for refractory symptoms.
Findings:
- The patient developed hypersalivation without extrapyramidal symptoms after initiating combination therapy.
- This suggests hypersalivation was an adverse effect of olanzapine, potentially exacerbated by interaction with fluvoxamine.
Implications:
- Combination therapy with atypical antipsychotics and SSRIs requires cautious administration and close patient monitoring.
- Understanding drug interactions is crucial for managing adverse effects in psychiatric treatment.
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