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The etiology and treatment of clozapine induced sialorrhoea

Defne Eraslan, Özgür Öztürk, Yasin Genç, Ayhan Kalyoncu.

Abstract
The side effects of clozapine which is a prominent
pharmacotherapeutic choice in resistant schizophrenia causes
important disadvantages. Although one third of patients on clozapine
treatment suffers from sialorrhoea, it is generally underevaluated.
This underevaluation causes the treatment choices to be limited . The
aim of this article is to attract the attention on the subject via
discussing the etiology and treatment of clozapine induced
sialorrhoea.
All articles related with clozapine induced sialorrhoea in PUBMED
between 1996-2006 were reviewed.
İt is not certainly known whether sialorrhoea induced by clozapine is
caused by impaired balance in muscarinic receptors and a2 receptor
blockade or impairment of swallowing reşex by clozapine. Except
from recovering swallowing reşex or lowering clozapine dose,
anticholinergic agents such as amitriptyiline, biperiden, ipratropium
bromide, a2 agonists such as clonidine and injection of botilinum
toxin might be of benefit in the treatment of clozapine induced
sialorrhoea.
None of the pharmacologic agents were found superior to each other
in the treatment of clozapine induced sialorrhoea. However, it is of
great importance to make the best treatment choice of sialorrhoea
and inform the patient about non-pharmacological prevention
methods in order to increase the quality of life and drug compliance.

Key words: Clozapine, sialorrhoea, resistant schizophrenia



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