Davydov L, Botts S R
College of Pharmacy and Allied Health Professions, St. John's University, Jamaica, NY, USA.
Ann Pharmacother. 2000 May;34(5):662-5. doi: 10.1345/aph.19259.
To review underlying pathophysiology and possible treatments for clozapine-induced hypersalivation.
Primary literature was accessed through MEDLINE (1966-May 1999). Key search terms included clozapine, hypersalivation, sialorrhea, and treatment.
Hypersalivation occurs in up to 54% of patients receiving clozapine. An evaluation of studies and case reports focusing on management of clozapine-induced hypersalivation was conducted.
It is unclear whether clozapine increases salivation through its muscarinic M4 receptor activation and/or blockade of alpha2-adrenoceptors, or by causing a distortion in swallowing reflex. Treatment options include chewing gum, reducing the dosage of clozapine, or prescribing pharmacologic agents such as anticholinergics or alpha2-adrenoceptor agonists.
回顾氯氮平所致流涎过多的潜在病理生理学机制及可能的治疗方法。
通过MEDLINE（1966年至1999年5月）检索原始文献。关键检索词包括氯氮平、流涎过多、唾液分泌过多及治疗。
接受氯氮平治疗的患者中，高达54%会出现流涎过多。对聚焦于氯氮平所致流涎过多管理的研究及病例报告进行了评估。
尚不清楚氯氮平是通过激活毒蕈碱M4受体和/或阻断α2肾上腺素能受体，还是通过导致吞咽反射异常来增加唾液分泌。治疗选择包括咀嚼口香糖、减少氯氮平剂量或开具抗胆碱能药物或α2肾上腺素能受体激动剂等药物。
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