Download PDF
Pharmacopsychiatry 2005; 38(1): 38-39
DOI: 10.1055/s-2005-837771
Letter
© Georg Thieme Verlag KG Stuttgart · New York

Reduction of Side Effects by Combining Clozapine with Amisulpride: Case Report and Short Review of Clozapine-Induced Hypersalivation

A Case ReportB. Croissant1 , D. Hermann1 , R. Olbrich1
  • 1Central Institute of Mental Health, University of Heidelberg, Mannheim, Germany
Further Information

Publication History

Received: 9.5.2004 Revised: 13.5.2004

Accepted: 8.6.2004

Publication Date:
11 February 2005 (online)

Also available at
    Permissions and Reprints

Side effects from a high-dose clozapine treatment for a schizophrenic patient led to massive compliance problems. The dose of clozapine could be halved without recurrence of an acute psychotic symptomatology by concomitantly administering amisulpride. The side effects, especially hypersalivation, disappeared almost entirely, which in turn led to good compliance. In a short review we would like to present the pathophysiology and therapeutic options of clozapine-induced hypersalivation.

References

  • 1 Alvir J M, Lieberman J A, Safferman A Z, Schwimmer J L, Schaaf J A. Clozapine-induced agranulocytosis. Incidence and risk factors in the United States.  N Engl J Med. 1993;  329 162-167
    CrossrefPubMedGoogle Scholar
  • 2 Ben Aryeh H, Jungerman T, Szargel R, Klein E, Laufer D. Salivary flow-rate and composition in schizophrenic patients on clozapine: subjective reports and laboratory data.  Biol Psychiatry. 1996;  39 946-949
    CrossrefPubMedGoogle Scholar
  • 3 Copp P J, Lament R, Tennent T G. Amitriptyline in clozapine-induced sialorrhoea.  Br J Psychiatry. 1991;  159 166
    PubMedGoogle Scholar
  • 4 Fritze J, Elliger T. Pirenzepine for clozapine-induced hypersalivation.  Lancet. 1995;  346 1034
    PubMedGoogle Scholar
  • 5 Schmauss M, Wolff R, Erfurth A, Ruther E. Tolerability of long term clozapine treatment.  Psychopharmacology (Berl). 1989;  99 (Suppl) S105-108
    CrossrefPubMedGoogle Scholar
  • 6 Schneider B, Weigmann H, Hiemke C, Weber B, Fritze J. Reduction of clozapine-induced hypersalivation by pirenzepine is safe.  Pharmacopsychiatry. 2004;  37 43-45
    Article in Thieme ConnectPubMedGoogle Scholar
  • 7 Spivak B, Adlersberg S, Rosen L, Gonen N, Mester R, Weizman A. Trihexyphenidyl treatment of clozapine-induced hypersalivation.  Int Clin Psychopharmacol. 1997;  12 213-215
    PubMedGoogle Scholar
  • 8 Szabadi E. Clozapine-induced hypersalivation and the alpha-2 adrenoceptor.  Br J Psychiatry. 1996;  169 380-381
    PubMedGoogle Scholar
  • 9 Szabadi E. Clozapine-induced hypersalivation.  Br J Psychiatry. 1997;  171 89
    PubMedGoogle Scholar
  • 10 Zink M, Knopf U, Henn F A, Thome J. Combination of clozapine and amisulpride in treatment-resistant schizophrenia case reports and review of the literature.  Pharmacopsychiatry.. 2004;  37 26-31
    Article in Thieme ConnectPubMedGoogle Scholar

Dr. Bernhard Croissant, MD

Department of Addictive Behavior and Addiction Medicine

Central Institute of Mental Health

University of Heidelberg

J 5

68159 Mannheim

Phone: +49 621 1703 3502

Fax: +49 621 1703 1205

Email: croissant@zi-mannheim.de

      >