A systematic chart review of pharmacological interventions in patients with clozapine-induced hypersalivation.

Autor: Mutlu E; Department of Psychiatry, Hacettepe University, Faculty of Medicine, Ankara, Turkey. Electronic address: mutluemre12@gmail.com., Özçelik Eroğlu E; Department of Psychiatry, Hacettepe University, Faculty of Medicine, Ankara, Turkey. Electronic address: elcin.ozcelik@hacettepe.edu.tr., Coşkun FÖ; Department of Psychiatry, Hacettepe University, Faculty of Medicine, Ankara, Turkey., Koçyiğit D; Department of Psychiatry, Hacettepe University, Faculty of Medicine, Ankara, Turkey., Canpolat İKN; Department of Psychiatry, Hacettepe University, Faculty of Medicine, Ankara, Turkey., Avcı H; Department of Biostatistics, Hacettepe University, Faculty of Medicine, Ankara, Turkey., Ertuğrul A; Department of Psychiatry, Hacettepe University, Faculty of Medicine, Ankara, Turkey. Electronic address: aertugru@hacettepe.edu.tr., Anıl Yağcıoğlu AE; Department of Psychiatry, Hacettepe University, Faculty of Medicine, Ankara, Turkey. Electronic address: eanil@hacettepe.edu.tr.
Jazyk: angličtina
Zdroj: Schizophrenia research [Schizophr Res] 2024 Jun; Vol. 268, pp. 138-144. Date of Electronic Publication: 2023 Aug 17.
DOI: 10.1016/j.schres.2023.08.004
Abstrakt: Objectives: To investigate the efficacy and tolerability of medications, such as mouthwash use of 1 % atropine sulfate and tropicamide drops, oral amitriptyline and amisulpride used for clozapine-induced hypersalivation (CIH).
Methods: The medical charts of inpatients with psychotic disorders between 2010 and 2022 were reviewed retrospectively. We detected 161 patients with eligible data who received or commenced clozapine. Primary outcome was defined as the percentage change in the diameter of a wet patch on the pillow (DWP) for improvements in CIH.
Results: The frequency of CIH was 42 % (n = 68). The first step medications for CIH were tropicamide drops (49 %), atropine drops (43 %) and amitriptyline (3 %). After the first step, the median DWP significantly decreased by -33 %. During the index hospitalization, in 18 patients with persistent CIH, the median DWP significantly decreased by -42 % with the second step medications which also included amisulpride. There were no reported serious adverse events. The change in DWP was significantly correlated with the duration of clozapine treatment (r = 306) and clozapine serum level at discharge (r = 0.294). A linear regression model showed a link between the change in DWP and reduced Positive and Negative Syndrome Scale scores.
Conclusions: Our findings emphasize that mouthwash use of atropine or tropicamide drops has a satisfying and tolerable effect in treating CIH. Switching medications for CIH seems to be effective when CIH persists despite a first step agent. Controlled follow-up studies are needed to understand the relationship between CIH, clozapine serum levels, illness severity, and functioning.
Competing Interests: Declaration of competing interest A.E.A.Y. has participated in advisory boards and received speaker's fees from Janssen and Abdi İbrahim Otsuka, and has received investigator fees from Janssen. E.M., E.Ö.E., F.Ö.C., D.K., İ.K.N.C., H.A., and A.E. declare that they have no conflict of interest.
(Copyright © 2023 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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