Review of Psychotropic Agents Associated with Sialorrhoea, Except Clozapine

Abstract

Introduction: Sialorrhoea, or excessive salivation, is common in psychiatric patients. This can be distressing because of its physical and psychosocial complications. Sialorrhoea due to psychotropic drugs has been reported repeatedly in the literature. Clozapine is the antipsychotic most commonly associated with sialorrhoea. Objective: The objective of this review was to examine and discuss the existing literature on all psychotropic drugs associated with sialorrhoea, except clozapine. Methods: Google Scholar and PubMed were searched for the literature on psychotropic-induced sialorrhoea. The search terms used were sialorrhoea, antidepressants, antipsychotics, mood stabilizer, and benzodiazepines. Case reports on patients suffering from psychotropic-induced sialorrhoea except clozapine are reviewed in this study. Results: The pathophysiology behind psychotropic-induced sialorrhoea, the population susceptible to sialorrhoea, and the exact duration from the start of sialorrhoea the drug course to the onset of sialorrhoea are unknown. Also, sialorrhoea is not associated with drug toxicity and is observed even in patients receiving normal doses of psychotropic medications. Treatment involves dose reduction, discontinuation of drugs responsible for the adverse effect, or adding anticholinergic drugs. Conclusion: Sialorrhoea due to clozapine has been reported in the literature. Many other antipsychotics, antidepressants such as sertraline, and other psychotropic drugs such as lithium have also been reported to cause sialorrhoea. No increase in the risk of sialorrhoea was seen in any of the age groups, and no association was found with treatment duration. In cases of lithium-induced sialorrhoea, no relationship was observed between serum levels of lithium and sialorrhoea.

The African Union's quest for a "peaceful and secure Africa": An assessment of Aspiration Four of Agenda 2063

“…175 In the aftermath of the latest coup, the United States condemned the coup and suspended USD 700 million worth of emergency aid, with the Secretary of State calling it a betrayal of the Sudanese peaceful revolution. 176 In response to the coup, and in line with its legal and policy framework on UCG, the AU condemned the coup and suspended Sudan's participation in all AU activities until the restoration of the civilian-led Transitional Authority. It requested the Commission Chairperson to provide monthly updates on the evolution of the situation in Sudan.…”

Lithium-Induced Sialorrhea

“…Sialorrhea, also known as excessive drooling, hypersalivation, or ptyalism, is common among psychiatric patients [ 9 ]. It has been implicated as a side effect of many psychotropic agents, for example, clozapine and olanzapine [ 9 ].…”

“…Sialorrhea, also known as excessive drooling, hypersalivation, or ptyalism, is common among psychiatric patients [ 9 ]. It has been implicated as a side effect of many psychotropic agents, for example, clozapine and olanzapine [ 9 ]. Other pathologies that can contribute to this phenomenon include postural dysfunction, saliva hypersecretion, dental malocclusion, and salivary spill recognition, especially in patients with neurologic illnesses [ 10 ].…”

“…Upon initiation of treatment, patients have also complained of tremors, weight gain, increased thirst, polyuria, and acne [3]. Sialorrhea, also known as excessive drooling, hypersalivation, or ptyalism, is common among psychiatric patients [9]. It has been implicated as a side effect of many psychotropic agents, for example, clozapine and olanzapine [9].…”