L Davydov1, S R Botts. 1. College of Pharmacy and Allied Health Professions, St. John's University, Jamaica, NY, USA.
Abstract
OBJECTIVE: To review underlying pathophysiology and possible treatments for clozapine-induced hypersalivation. DATA SOURCES: Primary literature was accessed through MEDLINE (1966-May 1999). Key search terms included clozapine, hypersalivation, sialorrhea, and treatment. DATA SYNTHESIS: Hypersalivation occurs in up to 54% of patients receiving clozapine. An evaluation of studies and case reports focusing on management of clozapine-induced hypersalivation was conducted. CONCLUSIONS: It is unclear whether clozapine increases salivation through its muscarinic M4 receptor activation and/or blockade of alpha2-adrenoceptors, or by causing a distortion in swallowing reflex. Treatment options include chewing gum, reducing the dosage of clozapine, or prescribing pharmacologic agents such as anticholinergics or alpha2-adrenoceptor agonists.
OBJECTIVE: To review underlying pathophysiology and possible treatments for clozapine-induced hypersalivation. DATA SOURCES: Primary literature was accessed through MEDLINE (1966-May 1999). Key search terms included clozapine, hypersalivation, sialorrhea, and treatment. DATA SYNTHESIS: Hypersalivation occurs in up to 54% of patients receiving clozapine. An evaluation of studies and case reports focusing on management of clozapine-induced hypersalivation was conducted. CONCLUSIONS: It is unclear whether clozapine increases salivation through its muscarinic M4 receptor activation and/or blockade of alpha2-adrenoceptors, or by causing a distortion in swallowing reflex. Treatment options include chewing gum, reducing the dosage of clozapine, or prescribing pharmacologic agents such as anticholinergics or alpha2-adrenoceptor agonists.
Authors: Juan A Gallego; Jimmi Nielsen; Marc De Hert; John M Kane; Christoph U Correll Journal: Expert Opin Drug Saf Date: 2012-05-08 Impact factor: 4.250