Sanagustin D, Martin-Subero M, Hogg B, Fortea L, Gardoki I, Guinart D, Roldán M, Angelats M, Cerro L, Navas D, Jiménez J D, Ortiz L, Ros R, Polo X, Ventura Y, Contreras J, Moreno-Alcázar A, Pérez-Sola V, Amann B L, Valiente-Gómez A
Psychiatric Services, Hospital Germans Trias I Pujol, Carretera de Canyet, S/N 08916, Badalona, Spain.
PhD Programme, Department of Psychiatry and Legal Medicine, Faculty of Medicine, Universitat Autònoma de Barcelona, Campus UAB, 08193, Cerdanyola del Vallès, Spain.
Psychopharmacology (Berl). 2023 Jan;240(1):203-211. doi: 10.1007/s00213-022-06294-3. Epub 2022 Dec 20.
Clozapine has proven to be superior to other antipsychotic drugs in the treatment of schizophrenia but is under-prescribed due to its potentially severe side effects. Clozapine-induced sialorrhea (CIS) is a frequent and extremely uncomfortable side effect, which remains understudied.
To examine the prevalence of diurnal and nocturnal CIS in a sample of patients treated with clozapine, and to evaluate its impact on quality of life.
We conducted a cross-sectional, observational study of 130 patients with schizophrenia spectrum disorders treated with clozapine. The prevalence of CIS was evaluated via specific sialorrhea scales. None of the patients included in the study was receiving a specific treatment for hypersalivation during the study period. Possible associations between sialorrhea and clinical and quality of life variables were analyzed.
Of 130 subjects, 120 (92.3%) suffered from CIS. Eighty-one (62.31%) suffered from diurnal CIS, 115 (88.56%) from nocturnal CIS, and 85 (65.38%) suffered from both. Significant positive associations between quality of life and diurnal CIS (B = 0.417; p = 2.1e - 6, R = 0.156) and nocturnal CIS (B = 0.411; p = 7.7e - 6, R = 0.139) were detected. Thirty per cent of the subjects reported a moderate to severe negative impact of sialorrhea on their quality of life.
The present study suggests that CIS is highly prevalent in patients with schizophrenia and has an important impact on quality of life in one-third of our sample. Therefore, the inclusion of a systematic evaluation and treatment of CIS in standard clinical practice is highly recommended.
Clinical Trials ( https://clinicaltrials.gov ) under reference NCT04197037.
氯氮平已被证明在治疗精神分裂症方面优于其他抗精神病药物，但由于其潜在的严重副作用，其处方量不足。氯氮平引起的流涎（CIS）是一种常见且极其令人不适的副作用，目前仍研究不足。
研究氯氮平治疗患者样本中白天和夜间CIS的患病率，并评估其对生活质量的影响。
我们对130例接受氯氮平治疗的精神分裂症谱系障碍患者进行了一项横断面观察性研究。通过特定的流涎量表评估CIS的患病率。在研究期间，纳入研究的患者均未接受针对唾液分泌过多的特定治疗。分析了流涎与临床及生活质量变量之间可能存在的关联。
在130名受试者中，120名（92.3%）患有CIS。81名（62.31%）患有白天CIS，115名（88.56%）患有夜间CIS，85名（65.38%）两者都有。检测到生活质量与白天CIS（B = 0.417；p = 2.1e - 6，R = 0.156）和夜间CIS（B = 0.411；p = 7.7e - 6，R = 0.139）之间存在显著正相关。30%的受试者报告流涎对其生活质量有中度至重度负面影响。
本研究表明，CIS在精神分裂症患者中非常普遍，并且在我们三分之一的样本中对生活质量有重要影响。因此，强烈建议在标准临床实践中纳入对CIS的系统评估和治疗。
