Amisulpride versus moclobemide in treatment of clozapine-induced hypersalivation.
OBJECTIVE
Previous publications demonstrated substitute benzamides as effective agents in treatment of clozapine-induced sialorrhea (CIS). The aim of this study was to compare efficacy of amisulpride and moclobemide (both from the substitute benzamide group) in controlling, or at least minimizing, CIS.


METHODS
The study was designed as a 6-week, two-center, fixed-dose, comparison study of 400 mg/day of amisulpride versus 300 mg/day of moclobemide as an adjunctive treatment in 53 schizophrenia and schizoaffective disorder patients (diagnosed according to DSM-IV) suffering from CIS. The patients were treated with each medication during 2 weeks, followed by a washout period of 2 weeks. Primary outcome measures included the reduction in the five-point Nocturnal Hypersalivation Rating Scale (NHRS). Secondary outcomes included the Positive and Negative Syndrome Scale (PANSS), Manic State Assessment Scale, and Extrapyramidal Symptom Rating Scale (ESRS).


RESULTS
Both amisulpride and moclobemide were very effective in reducing CIS. Almost 74% of patients treated with amisulpride and 83% of patients treated with moclobemide showed some level of improvement on NHRS. Only in one patient treated with amisulpride, CIS worsened.


CONCLUSIONS
Both medications were safe and effective as treatment of CIS. Although moclobemide exceeded amisulpride in antisalivation activity, treatment of CIS with amisulpride leads to improvement in psychotic symptoms.
Mental Health Center Tirat Carmel, Bruce Rapaport Faculty of Medicine Technion-Haifa, Israel.
Anatoly
A
Kreinin
Chanoch
C
Miodownik
Shmuel
S
Sokolik
Diana
D
Shestakova
Igor
I
Libov
Joseph
J
Bergman
Vladimir
V
Lerner
D000328:Adult; D000368:Aged; D000077582:Amisulpride; D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D003024:Clozapine / Q000009:adverse effects* / Q000627:therapeutic use; D018592:Cross-Over Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020912:Moclobemide / Q000627:therapeutic use*; D011618:Psychotic Disorders / Q000188:drug therapy; D012559:Schizophrenia / Q000188:drug therapy; D012720:Severity of Illness Index; D012798:Sialorrhea / Q000139:chemically induced / Q000188:drug therapy*; D013469:Sulpiride / Q000031:analogs & derivatives* / Q000627:therapeutic use
D014150:Antipsychotic Agents; D013469:Sulpiride; D000077582:Amisulpride; D003024:Clozapine; D020912:Moclobemide