Clozapine-induced hypersalivation.
OBJECTIVE
To review underlying pathophysiology and possible treatments for clozapine-induced hypersalivation.


METHODS
Primary literature was accessed through MEDLINE (1966-May 1999). Key search terms included clozapine, hypersalivation, sialorrhea, and treatment.


RESULTS
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.
Davydov
L
L
College of Pharmacy and Allied Health Professions, St. John's University, Jamaica, NY, USA.
Botts
S R
SR
D000322:Adrenergic Agonists / Q000627:therapeutic use; D014150:Antipsychotic Agents / Q000009:adverse effects*; D018680:Cholinergic Antagonists / Q000627:therapeutic use; D003024:Clozapine / Q000009:adverse effects*; D016903:Drug Monitoring; D006801:Humans; D012798:Sialorrhea / Q000139:chemically induced* / Q000188:drug therapy / Q000503:physiopathology
D000322:Adrenergic Agonists; D014150:Antipsychotic Agents; D018680:Cholinergic Antagonists; D003024:Clozapine