Abstract | OBJECTIVE: CASE SUMMARY: A 53-year-old female with schizoaffective disorder-bipolar type was admitted to a psychiatric unit and initiated on clozapine. During titration to a dose of 300 mg daily and despite taking concomitant oral benztropine 1 mg twice daily, the patient began to experience mild sialorrhea. The sialorrhea became profuse when the clozapine dose reached 400 mg daily, and the patient was routinely seen with a saliva-soaked shirt. Additionally, she had become self-conscious and wanted to stop clozapine therapy. Immediate-release oxybutynin 5 mg daily was started, resulting in significant reduction of the sialorrhea within 24 hours. The patient was discharged on clozapine 300 mg daily, risperidone 6 mg at bedtime, immediate-release oxybutynin 5 mg twice daily, and oral benztropine 1.5 mg daily, with only mild sialorrhea. DISCUSSION: CONCLUSIONS: To our knowledge, this is the first report of immediate-release oxybutynin successfully reducing clozapine-induced sialorrhea. If oxybutynin is considered for this indication, use of the immediate-release formulation seems prudent. Additional data, including randomized controlled trials, are needed to confirm whether immediate-release oxybutynin has a significant role in the management of this stigmatizing adverse effect.
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Authors | Jonathan G Leung, Neil V Puri, Michael J Jacobson |
Journal | The Annals of pharmacotherapy
(Ann Pharmacother)
Vol. 45
Issue 9
Pg. e45
(Sep 2011)
ISSN: 1542-6270 [Electronic] United States |
PMID | 21852588
(Publication Type: Case Reports, Journal Article)
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Chemical References |
- Antipsychotic Agents
- Mandelic Acids
- Muscarinic Antagonists
- Clozapine
- oxybutynin
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Topics |
- Antipsychotic Agents
(adverse effects, therapeutic use)
- Bipolar Disorder
(drug therapy)
- Clozapine
(adverse effects, therapeutic use)
- Female
- Humans
- Mandelic Acids
(administration & dosage, therapeutic use)
- Middle Aged
- Muscarinic Antagonists
(administration & dosage, therapeutic use)
- Psychotic Disorders
(drug therapy)
- Sialorrhea
(chemically induced, drug therapy)
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