Sulpiride addition for the treatment of clozapine-induced hypersalivation: preliminary study.
BACKGROUND
Hypersalivation is a common, troublesome side effect of clozapine treatment. It occurs in 31-54% of clozapine treated patients. Management of this stigmatizing side effect may reduce noncompliance. Reports in the literature have shown beneficial clinical effects of combined clozapine-sulpiride therapy as measured by the Brief Psychiatric Rating Scale, and we found that this treatment combination also has very strong antisalivatory activity for clozapine-induced hypersalivation.


METHODS
18 patients (12 female, 6 male) with clozapine-induced hypersalivation received sulpiride (150-300 mg/day) in addition to ongoing clozapine treatment (from 100 mg/d to 800 mg/d). Baseline, 7 day and 21 day follow-up values were recorded for the 5-point Nocturnal Hypersalivation Rating Scale.


RESULTS
At the end of the trial only 3 patients complained of minimal sialorrhea, and the mean Nocturnal Hypersalivation Rating Scale scale values showed a significant reduction in sialorrhea (delta baseline-endpoint -.2.78 +/- 0.87).


CONCLUSIONS
Our findings support reports of the beneficial effect of clozapine-sulpiride combination therapy and suggest that sulpiride addition may contribute to the amelioration of clozapine-induced hypersalivation.
Kreinin
Anatoly
A
Tirat HaCarmel Mental Health Center, Tirat HaCarmel, Israel. tyrkreinin@matat.health.gov.il
Epshtein
Svetlana
S
Sheinkman
Ayala
A
Tell
Emanuel
E
D000328:Adult; D018687:Antidepressive Agents, Second-Generation / Q000627:therapeutic use*; D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D003024:Clozapine / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D012559:Schizophrenia / Q000188:drug therapy*; D012798:Sialorrhea / Q000139:chemically induced*; D013469:Sulpiride / Q000627:therapeutic use*
D018687:Antidepressive Agents, Second-Generation; D014150:Antipsychotic Agents; D013469:Sulpiride; D003024:Clozapine