title: Clozapine-induced sialorrhea: pathophysiology and management strategies.
abstract: BACKGROUND
  Clozapine is an atypical antipsychotic agent with proven efficacy in refractory schizophrenia, but its widespread use is limited by adverse effects such as agranulocytosis, seizures, sedation, weight gain, and sialorrhea. Clozapine-induced sialorrhea (CIS) is bothersome and has socially stigmatizing adverse effects, which result in poor treatment compliance. The pathophysiology of this condition is poorly understood and the treatment options available are based mostly on case reports and open-label studies.
  
  
  OBJECTIVE
  To review the available studies on CIS.
  
  
  METHODS
  All relevant studies available through PUBMED search supplemented with manual search were undertaken.
  
  
  RESULTS
  The clinical features, complications, assessment, pathophysiology, and management of CIS are discussed.
  
  
  CONCLUSIONS
  Although the studies evaluating the therapeutic options has limitations and no drug has been found to be superior, judicious use of pharmacological agents along with behavioral methods will reduce this troublesome side effect and enhance compliance.
authors.affiliation: Central Institute of Psychiatry, Ranchi, Jharkhand, 864006, India. samirpsyche@yahoo.co.in
authors.forename: Samir Kumar
authors.initials: SK
authors.lastname: Praharaj
authors.forename: Manu
authors.initials: M
authors.lastname: Arora
authors.forename: Sachin
authors.initials: S
authors.lastname: Gandotra
mesh_terms: D000316:Adrenergic alpha-Agonists / Q000627:therapeutic use; D014150:Antipsychotic Agents / Q000009:adverse effects*; D018680:Cholinergic Antagonists / Q000627:therapeutic use; D003024:Clozapine / Q000009:adverse effects*; D006801:Humans; D012798:Sialorrhea / Q000139:chemically induced* / Q000188:drug therapy / Q000503:physiopathology*
chemical_list: D000316:Adrenergic alpha-Agonists; D014150:Antipsychotic Agents; D018680:Cholinergic Antagonists; D003024:Clozapine