van der Poorten T, De Hert M
Tijdschr Psychiatr. 2019;61(6):403-410.
In patients taking clozapine, about 30% experience sialorrhoea, with its related potentially important medical and psychosocial implications. Until now, systemic treatments have been unsuccessful and also have unfavourable side-effects.
AIM: To examine the current evidence regarding the use of local atropine in clozapine-induced sialorrhoea (cis), as well as for sialorrhoea of other etiology.
METHOD: PubMed and Google Scholar were searched using the keywords 'sialorrhea', 'clozapine' and 'atropine' to investigate the use of sublingual atropine for cis, as well as for sialorrhoea of other etiology. Two patients are described and discussed.
RESULTS: Of 24 identified patients, 21 experienced a beneficial effect on cis with sublingually administered atropine eye drops or 1% ipratropium bromide nasal spray (0.03%). Side-effects, such as a dry mouth, unpleasant taste and short duration of action of the eye drops, were reported. Of the 67 patients treated with local atropine for sialorrhoea of other etiology, generally a beneficial effect and few side-effects were reported.
CONCLUSION: The sublingual administration of atropine appears to be effective in the treatment of cis, as well as in sialorrhoea of other etiology. The dose is usually 1-2 eye drops, two to three times per day.
服用氯氮平的患者中，约30%会出现流涎，这会带来相关的潜在重要医学和社会心理问题。到目前为止，全身治疗均未成功，且存在不良副作用。
研究关于局部使用阿托品治疗氯氮平所致流涎（CIS）以及其他病因所致流涎的现有证据。
使用关键词“流涎”“氯氮平”和“阿托品”在PubMed和谷歌学术上进行检索，以调查舌下含服阿托品治疗CIS以及其他病因所致流涎的情况。描述并讨论了两名患者。
在24例已确定的患者中，21例使用舌下含服阿托品滴眼液或1%异丙托溴铵鼻喷雾剂（0.03%）治疗CIS取得了有益效果。报告了口干、味道不佳以及滴眼液作用持续时间短等副作用。在67例因其他病因所致流涎而接受局部阿托品治疗的患者中，总体上报告了有益效果且副作用较少。
舌下含服阿托品似乎对治疗CIS以及其他病因所致流涎有效。剂量通常为1 - 2滴眼药水，每天两到三次。
