Glycopyrrolate for treatment of clozapine-induced sialorrhea in three adolescents.
OBJECTIVE
The aim of this case study was to report preliminary data on the effectiveness and tolerability of glycopyrrolate for the treatment of clozapine-induced sialorrhea, or excessive flow of saliva, in an adolescent population.


METHODS
Three adolescent females (age 13-16), who developed sialorrhea secondary to clozapine treatment, received an open-label trial of glycopyrrolate (4-8 mg) during inpatient hospitalization for treatment-resistant psychotic illness.


RESULTS
The target symptom of sialorrhea was improved in all three cases, with patient self-reports of decreased production of saliva confirmed by staff observation. Glycopyrrolate was generally well tolerated by the patients. One patient reported constipation, which improved with symptomatic treatment. A second patient reported dry mouth, which improved with a reduction in dose of glycopyrrolate.


CONCLUSIONS
These three cases provide support for the potential effectiveness and tolerability of glycopyrrolate for clozapine-induced sialorrhea in adolescents. Further controlled studies are required to determine the safety, efficacy and tolerability of glycopyrrolate in this age group and in adults for clozapine-induced sialorrhea.
Robb
Adelaide S
AS
Department of Psychiatry and Behavioral Sciences, Children's National Medical Center, 111 Michigan Avenue NW, Washington, D.C., USA. arobb@cnmc.org
Lee
Ronald H
RH
Cooper
Erin B
EB
Siedel
John V
JV
Nusrat
Nasima
N
D000293:Adolescent; D014150:Antipsychotic Agents / Q000009:adverse effects*; D003024:Clozapine / Q000009:adverse effects*; D005260:Female; D006024:Glycopyrrolate / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D012798:Sialorrhea / Q000139:chemically induced / Q000188:drug therapy*
D014150:Antipsychotic Agents; D003024:Clozapine; D006024:Glycopyrrolate