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Journal of Psychopharmacology
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Is clonidine useful for treatment of clozapine-induced sialorrhea?

Samir Kumar Praharaj

Senior Resident, Department of Psychiatry, Dr Ram Manohar Lohia Hospital, New Delhi, India., samirpsyche{at}yahoo.co.in

Pankaj Verma

Senior Resident, Department of Psychiatry, Dr Ram Manohar Lohia Hospital, New Delhi, India.

Dipayan Roy

Senior Resident, Department of Psychiatry, Dr Ram Manohar Lohia Hospital, New Delhi, India.

Anuradha Singh

Senior Resident, Department of Psychiatry, Dr Ram Manohar Lohia Hospital, New Delhi, India.

Clozapine has shown superior efficacy in treatment of refractory schizophrenia, but its use is limited by emergent side-effects. Among other adverse effects, sialorrhea is a troublesome side-effect, its stigmatizing nature results in poor treatment compliance. Several hypotheses have been put forward in the etiology of clozapine-induced sialorrhea. 2 adrenergic antagonism is hypothesized to be involved in its pathophysiology, based on the response to clonidine and lofexidine. Oral clonidine (50 to 100 g/day) was tried on 12 stable outpatients of schizophrenia maintained on clozapine. Wet area over the pillow as reported by the patients was recorded at baseline and at 4 weeks of treatment along with the subjective response after the treatment. Most of the patients reported a decrease in sialorrhea without any adverse events. We describe encouraging results in an open case series of oral clonidine for clozapine-induced sialorrhea.

Key Words: clozapine • clonidine • sialorrhea

Journal of Psychopharmacology, Vol. 19, No. 4, 426-428 (2005)
DOI: 10.1177/0269881105053311
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