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Psychiatric Bulletin (2001) 25: 114-116. doi: 10.1192/pb.25.3.114
© 2001 The Royal College of Psychiatrists
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Psychiatric Bulletin (2001) 25: 114-116
© 2001 The Royal College of Psychiatrists


Drug information quarterly

A review of the treatment options for clozapine-induced hypersalivation

Adrian Cree, Senior House Officer, Shameem Mir, Principal Liaison Pharmacist and Thomas Fahy, Consultant Psychiatrist

Maudsley Hospital, Denmark Hill, London SE5 8AF

AIMS AND METHOD

To develop and introduce an evidence-based drug treatment protocol for clozapine-induced hypersalivation, a review of published literature relating to clozapine-induced hypersalivation and its treatment was undertaken in March 2000. The databases searched were Medline, EMBASE and PsychLit, from 1966 to the present.

RESULTS

This paper reviews the evidence of the benefit of using antimuscarinic agents, adrenergic antagonists and adrenergic agonists. There is a lack of good-quality controlled-trials, with most papers reporting a series of uncontrolled cases dependent on subjective measures of improvement reported by the patients. However, the published literature suggests a benefit for all of the drug categories reviewed. The most effective treatment may be a combination of terazosin and benzhexol.

CLINICAL IMPLICATIONS

Clozapine-induced hypersalivation is not only an embarrassing problem, but can be difficult to treat. An evidence-based prescribing protocol will encourge the use of those drugs found to be the most effective in treating this problem. It will also offer alternatives if a certain treatment is ineffective or intolerable.







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British Journal of Psychiatry Advances in Psychiatric Treatment All RCPsych Journals
Copyright © 2001 The Royal College of Psychiatrists.