Clozapine-Induced Hypersalivation: A Review of Treatment Strategies

Abstract

Although few randomized controlled trials were found in the literature, this review highlights potential treatment alternatives for this common and disabling cause of hypersalivation. Prompt and effective treatment of CIH may assist with treatment tolerability, adherence, and outcomes in patients with treatment-refractory schizophrenia. Information on funding and support and author affiliations appears at the end of the article.

Pharmacological and behavioral management of some often-overlooked clozapine-induced side effects

“…There is a scarcity of information in the medical literature on established strategies to deal with this issue, and the studies available have methodological problems, such as small sample sizes, a short follow-up period, and the lack of a control group. Syed et al (2008) argue these points as do other researchers (Sockalingam et al, 2007;Bird et al, 2011). We may thus conclude that there are no unequivocal guidelines at this time for the proper treatment of hypersalivation associated with clozapine treatment and neither is there a drug of choice.…”

Amisulpride Improved Debilitating Clozapine-Induced Sialorrhea

“…2,3 Pharmacologic treatment of clozapine induced sialorrhea (CIS) includes amitryptiline, clonidine, pirenzepine, trihexyphenidyl, benztropine, ipatropium bromide, and atropine. 2,4 Recent reports suggest beneficial effect of sulpiride 5 and the related drug, amisulpride, which has a higher selective binding to the D2/D3 dopamine receptor, in refractory cases of CIS. 4 …”

“…2,4 Recent reports suggest beneficial effect of sulpiride 5 and the related drug, amisulpride, which has a higher selective binding to the D2/D3 dopamine receptor, in refractory cases of CIS. 4 …”

Amisulpride versus moclobemide in treatment of clozapine-induced hypersalivation

“…It occurs in between 10 and 72% of patients treated with clozapine (Soler Roibal et al 1999). with an average rate of 30% (Davydov and Botts 2000;Rogers and Shramko 2000;Sockalingam et al 2007). Beside the external manifestations related to hypersalivation, additional consequences of hypersalivation include painful parotid gland swelling and parotid duct obstruction due to the formation of calculi (Robinson et al 1995;Brodkin et al 1996;Conry et al 1996).…”