Sublingual atropine in the treatment of clozapine-induced sialorrhea
Section snippets
Discussion
CIS is a common and bothersome side effect of clozapine (Sagy et al., 2014, Syed et al., 2008). As presented in the three cases above, CIS can occur at different clozapine doses, in various stages of treatment, and can interfere with treatment adherence. Oral anticholinergic and alpha-2 agonist medications have been used to treat CIS with variable efficacy, but can cause systemic anticholinergic side effects (i.e., constipation, urinary retention, cardiac arrhythmia)(Syed et al. 2008). These
Contributors
All four authors have contributed.
Role of funding source
None.
Conflict of interest
None.
Acknowledgments
None.
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Oral Health Needs and Experiences of Medicaid Enrollees With Serious Mental Illness
2018, American Journal of Preventive MedicineCitation Excerpt :In 2015, a total of 9.1 million adults on Medicaid had a diagnosed mental health condition.10 This population of Medicaid enrollees experiences numerous risks to oral health compared with the general population, including (1) use of medications that cause dry mouth or hypersalivation18–21; (2) higher rates of smoking and substance use19,20; (3) less healthy diets22; (4) overall poor physical health23; and (5) social issues, such as high rates of homelessness and poverty.18,20,23 Underutilization of dental services, especially preventive services, among individuals with serious mental illness (SMI) is another risk factor.24
Monitoring oral health of people in Early Intervention for Psychosis (EIP) teams: The extended Three Shires randomised trial
2018, International Journal of Nursing StudiesCitation Excerpt :Hypersalivation is also a side effect of treatment with clozapine. There are also neurological effects of first-generation antipsychotics (dystonia, dyskinesia) and second-generation antipsychotics induce more metabolic side effects like obesity or diabetes and these are linked to periodontal diseases (Fratto and Manzon, 2014; Matos Santana et al., 2017; Vancampfort et al., 2015). A meta-analysis of fifty seven studies looking at the prevalence of suboptimal oral health of people with mental illness, found a suboptimal oral health prevalence of 61% as well as highlighting the need for oral health training for mental health professionals (Matevosyan, 2010).
Perphenazine-induced sialorrhea successfully treated with sublingual atropine: A case report
2019, Personalized Medicine in PsychiatryCitation Excerpt :One common pharmacologic treatment is antimuscarinics such as benztropine, trihexyphenidyl, glycopyrrolate, and atropine. Atropine sublingual drops, which have long been used for drooling in disorders such as cerebral palsy [9], have demonstrated efficacy in clozapine-induced sialorrhea [7,8,10]. Another approach is the use of a centrally-acting alpha-2 adrenergic agonist, most often clonidine, usually used as a patch to prevent rapid fluctuations in blood pressure [7,8,11].
Use of Sublingual Atropine Drops in Clozapine-Associated Sialorrhea in an Adolescent Patient: A Case Report
2022, Journal of Clinical Psychopharmacology