Treatment of clozapine-induced hypersalivation with ipratropium bromide: A randomized, double-blind, placebo-controlled crossover study

Journal of Clinical Psychiatry

Volumn 70, Issue 8, 2009, Pages 1114-1119

  Sockalingam, Sanjeev ^a,d   Shammi, Chekkera ^b,c,d   Remington, Gary ^c,d  

^a UNIVERSITY HEALTH NETWORK   (Canada)

^b CENTRE FOR ADDICTION AND MENTAL HEALTH   (Canada)

^c Schizophrenia Program

^d UNIVERSITY OF TORONTO   (Canada)

Author keywords

[No Author keywords available]

Indexed keywords

CLOZAPINE; IPRATROPIUM BROMIDE; PLACEBO; CHOLINERGIC RECEPTOR BLOCKING AGENT;

ADULT; ARTICLE; CLINICAL ARTICLE; CLINICAL TRIAL; CONTROLLED CLINICAL TRIAL; CONTROLLED STUDY; CROSSOVER PROCEDURE; DISEASE SEVERITY; DOUBLE BLIND PROCEDURE; DRUG BLOOD LEVEL; DRUG EFFICACY; DRUG TOLERABILITY; FEMALE; HUMAN; HYPERSALIVATION; MALE; OUTCOME ASSESSMENT; PRIORITY JOURNAL; RANDOMIZED CONTROLLED TRIAL; RATING SCALE; TREATMENT DURATION; VISUAL ANALOG SCALE; XEROSTOMIA; ADOLESCENT; AGED; CHEMICALLY INDUCED DISORDER; COMPARATIVE STUDY; HOSPITALIZATION; MIDDLE AGED; PSYCHOSIS; QUESTIONNAIRE; SCHIZOPHRENIA; TREATMENT OUTCOME;

ADOLESCENT; ADULT; AGED; CHOLINERGIC ANTAGONISTS; CLOZAPINE; CROSS-OVER STUDIES; DOUBLE-BLIND METHOD; FEMALE; HUMANS; IPRATROPIUM; MALE; MIDDLE AGED; PSYCHOTIC DISORDERS; QUESTIONNAIRES; SCHIZOPHRENIA; SEVERITY OF ILLNESS INDEX; SIALORRHEA; TREATMENT OUTCOME;

EID: 70349576484     PISSN: 01606689     EISSN: None     Source Type: Journal    
DOI: 10.4088/JCP.08m04495     Document Type: Article

References (43)

1. Kane J, Honigfeld G, Singer J, et al. Clozapine for the treatment-resistant schizophrenic: a double-blind comparison with chlorpromazine. Arch Gen Psychiatry. 1988;45:789-796. PubMed (Pubitemid 18222922)
2. McEvoy JP, Lieberman JA, Stroup TS, et al. Effectiveness of clozapine versus olanzapine, quetiapine, and risperidone in patients with chronic schizophrenia who did not respond to prior atypical antipsychotic treatment. Am J Psychiatry. 2006;163(4):600-610. PubMed doi:10.1176/appi.ajp.163.4.600
3. Honigfeld G. Effects of the clozapine national registry system on incidence of deaths related to agranulocytosis. Psychiatr Serv. 1996;47(1):52-56. PubMed (Pubitemid 26023948)
4. Safferman A, Lieberman JA, Kane JM, et al. Update on the clinical efficacy and side effects of clozapine. Schizophr Bull. 1991;17(2):247-261. PubMed
5. Yusufi B, Mukherjee S, Flanagan R, et al. Prevalence and nature of side effects during clozapine maintenance treatment and the relationship with clozapine dose and plasma concentration. Int Clin Psychopharmacol. 2007;22(4):238-243. PubMed doi:10.1097/YIC.0b013e32819f8f17 (Pubitemid 46801948)
6. Khan AY, Preskorn SH. Examining concentration-dependent toxicity of clozapine: role of therapeutic drug monitoring. J Psychiatr Pract. 2005;11(5):289-301. PubMed doi:10.1097/00131746-200509000-00003
7. Hinkes R, Quesada T, Currier MB, et al. Aspiration pneumonia possibly secondary to clozapine-induced sialorrhea. J Clin Psychopharmacol. 1996;16(6):462-463. PubMed doi:10.1097/00004714-199612000-00013 (Pubitemid 26423315)
8. McCarthy RH, Terkelsen KG. Esophageal dysfunction in two patients after clozapine treatment. J Clin Psychopharmacol. 1994;14(4):281-283. PubMed doi:10.1097/00004714-199408000-00012
9. Pearlman C. Clozapine, nocturnal sialorrhea, and choking. (letter) J Clin Psychopharmacol. 1994;14(4):283. PubMed doi:10.1097/00004714-199408000-00013 (Pubitemid 24254725)
10. Zorn SH, Jones SB, Ward KM, et al. Clozapine is a potent and selective muscarinic M4 receptor agonist. Eur J Pharmacol. 1994;269(3):R1-R2. PubMed doi:10.1016/0922-4106(94)90047-7
11. Perkins DO, McClure RK. Hypersalivation coincident with olanzapine treatment. Am J Psychiatry. 1998;155:993-994. PubMed
12. Schneider B, Weigmann H, Hiemke C, et al. Reduction of clozapine-induced hypersalivation by pirenzepine is safe. Pharmacopsychiatry. 2004;37(2):43-45. PubMed doi:10.1055/s-2004-815523 (Pubitemid 38651015)
13. Baldessarini RJ, Frankenburg FR. Clozapine: a novel antipsychotic agent. N Engl J Med. 1991;324(11):746-754. PubMed
14. Ben-Aryeh H, Jungerman T, Szargel R, et al. Salivary flow-rate and composition in schizophrenic patients on clozapine: subjective reports and laboratory data. Biol Psychiatry. 1996;39:946-949. PubMed doi:10.1016/0006- 3223(95)00296-0 (Pubitemid 126334217)
15. Berlan M, Montastruc JL, Lafontan M. Pharmacological prospects for alpha 2-adrenoceptor antagonist therapy. Trends Pharmacol Sci. 1992;13(7):277-282. PubMed doi:10.1016/0165-6147(92)90085-K
16. Sockalingam S, Shammi C, Remington G. Clozapine-induced hypersalivation: a review of treatment strategies. Can J Psychiatry. 2007;52(6):377-384. PubMed (Pubitemid 46997312)
17. Praharaj SK, Arora M, Gandotra S. Clozapine-induced sialorrhea: pathophysiology and management strategies. Psychopharmacology (Berl). 2006;185(3):265-273. PubMed doi:10.1007/s00213-005-0248-4
18. Bai YM, Lin CC, Chen JY, et al. Therapeutic effect of pirenzepine for clozapine-induced hypersalivation: a randomized, double-blind, placebo-controlled, cross-over study. J Clin Psychopharmacol. 2001;21(6):608-611. PubMed doi:10.1097/00004714-200112000-00012
19. Calderon J, Rubin E, Sobota WL. Potential use of ipratropium bromide for the treatment of clozapine-induced hypersalivation: a preliminary report. Int Clin Psychopharmacol. 2000;15:49-52. PubMed doi:10.1097/00004850-200015010-00008 (Pubitemid 30058140)
20. Comley C, Galletly C, Ash D. Use of atropine eye drops for clozapine-induced hypersalivation. Aust N Z J Psychiatry. 2000;34:1033-1034. PubMed doi:10.1080/000486700285
21. Copp PJ, Lament R, Tennent TG. Amitriptyline in clozapine-induced sialorrhoea. Br J Psychiatry. 1991;159:166. PubMed doi:10.1192/bjp.159.1.166a
22. Freudenreich O, Beebe M, Goff DC. Clozapine-induced sialorrhea treated with sublingual ipratropium spray: a case series. J Clin Psychopharmacol. 2004;24(1):98-100. PubMed doi:10.1097/01.jcp.0000106228.36344.2e (Pubitemid 38134176)
23. Gaftanyuk O, Trestman RL. Scopolamine patch for clozapine-induced sialorrhea. Psychiatr Serv. 2004;55(3):318. PubMed doi:10.1176/appi.ps.55.3.318
24. McKane JP, Hall C, Akram G. Hyoscine patches in clozapine-induced hypersalivation. (letter) Psychiatr Bull. 2001;25:277. doi:10.1192/pb.25.7.277-c
25. Reinstein MJ, Sirotovskaya LA, Chasanov MA, et al. Comparative efficacy and tolerability of benzatropine and terazosin in the treatment of hypersalivation secondary to clozapine. Clin Drug Investig. 1999;17(2):97-102. doi:10.2165/00044011-199917020-00003
26. Sharma A, Ramaswamy S, Dahl E, et al. Intraoral application of atropine sulfate ophthalmic solution for clozapine-induced sialorrhea. Ann Pharmacother. 2004;38(9):1538. PubMed (Pubitemid 39100214)
27. Spivak B, Adlersberg S, Rosen L, et al. Trihexyphenidyl treatment of clozapine-induced hypersalivation. Int Clin Psychopharmacol. 1997;12(4):213-215. PubMed doi:10.1097/00004850-199707000-00005
28. Tessier P, Antonello C. Clozapine and sialorrhea: update. J Psychiatry Neurosci. 2001;26(3):253. PubMed
29. Robb AS, Lee RH, Cooper EB, et al. Glycopyrrolate for treatment of clozapine-induced sialorrhea in three adolescents. J Child Adolesc Psychopharmacol. 2008;18(1):99-107. PubMed doi:10.1089/cap.2007.0037
30. Richardson C, Kelly DL, Conley RR. Biperiden for excessive sweating from clozapine. Am J Psychiatry. 2001;158(8):1329-1330. PubMed doi:10.1176/appi.ajp. 158.8.1329-a
31. Fritze J, Elliger T. Pirenzepine for clozapine-induced hypersalivation. Lancet. 1995;346:1034. PubMed doi:10.1016/S0140-6736(95)91713-6
32. Croissant B, Hermann D, Olbrich R. Reduction of side effects by combining clozapine with amisulpride: case report and short review of clozapine-induced hypersalivation: a case report. Pharmacopsychiatry. 2005;38:38-39. PubMed doi:10.1055/s-2005-837771 (Pubitemid 40278646)
33. Grabowski J. Clonidine treatment of clozapine-induced hypersalivation. J Clin Psychopharmacol. 1992;12(1):69-70. PubMed doi:10.1097/00004714-199202000- 00026
34. Kreinin A, Epshtein S, Sheinkman A, et al. Sulpride addition for the treatment of clozapine-induced hypersalivation: preliminary study. Isr J Psychiatry Relat Sci. 2005;42(1):61-63. PubMed (Pubitemid 41159765)
35. Kreinin A, Novitski D, Weizman A. Amisulpride treatment of clozapine-induced hypersalivation in schizophrenia patients: a randomized, double-blind, placebo-controlled cross-over study. Int Clin Psychopharmacol. 2006;21:99-103. PubMed doi:10.1097/01.yic.0000188216.92408.69 (Pubitemid 43740317)
36. Praharaj SK, Verma P, Roy D, et al. Is clonidine useful for treatment of clozapine-induced sialorrhea. J Psychopharmacol. 2005;19(4):426-428. PubMed doi:10.1177/0269881105053311 (Pubitemid 41003141)
37. Freudenreich O, Goff DC. Colon perforation and peritonitis associated with clozapine. J Clin Psychiatry. 2000;61:950-951. PubMed (Pubitemid 32058015)
38. Laurikainen E, Koulu M, Kaila T, et al. Evaluation of the systemic anticholinergic activity of nasally administered ipratropium bromide. Rhinology. 1988;26(2):133-138. PubMed (Pubitemid 18185153)
39. Appelbaum PS, Grisso T. MacArthur Competence Tool for Clinical Research. Sarasota, FL: Professional Resource Press; 2001.
40. Guy W. ECDEU Assessment Manual for Psychopharmacology. Revised DHEW Publication (ADM). Rockville, MD: National Institute of Mental Health; 1976:218-222.
41. Simpson GM, Angus JW. A rating scale for extrapyramidal side effects. Acta Psychiatr Scand Suppl. 1970;212:11-19. PubMed doi:10.1111/j.1600-0447.1970. tb02066.x
42. Ondo WG, Hunter C, Moore W. A double-blind placebo-controlled trial of botulinum toxin B for sialorrhea in Parkinson's disease. Neurology. 2004;62:37-40. PubMed (Pubitemid 38082867)
43. Suskind DL, Titon A. Clinical study of botulinum: a toxin in the treatment of sialorrhea with children with cerebral palsy. Laryngoscope. 2002;112:73-81. PubMed doi:10.1097/00005537-200201000-00014