Kitsinthopchai Chanunnat, Kumpeera Siripun, Sangngarm Apiradee, Boonlue Tuanthon
Faculty of Pharmaceutical Sciences, Ubon Ratchathani University, Ubon Ratchathani, Thailand.
Prasrimahabhodi Psychiatric Hospital, Ubon Ratchathani, Thailand.
Hosp Pharm. 2024 Dec 17:00185787241306445. doi: 10.1177/00185787241306445.
Hypersalivation, or excessive production and secretion of saliva, can result from associated disorders or adverse drug reactions. It significantly impacts physical health, psychosocial well-being, and quality of life. Clozapine, a gold standard for treatment-resistant schizophrenia, is known to cause hypersalivation in some patients. This study aimed to determine the prevalence of hypersalivation and identify factors associated with its occurrence in patients with schizophrenia treated with clozapine, either as monotherapy or in combination with other antipsychotics. This retrospective cohort study was conducted using medical records from inpatients diagnosed with schizophrenia at a tertiary psychiatric hospital. Data were collected from patients treated with clozapine between June 1, 2020, and December 31, 2020. Descriptive statistics were used to describe the prevalence of hypersalivation, and multiple logistic regression was performed to assess the association between hypersalivation and patient characteristics. A total of 96 patients were included in the study, with a mean age of 44.03 years (SD = 13.27); 72.9% of the patients were male. The overall prevalence of hypersalivation was 14.6%, with 19.51% of patients on clozapine monotherapy and 10.91% of those on clozapine combined with other antipsychotics experiencing hypersalivation. Male sex appeared to reduce the risk for hypersalivation (adjusted OR: 0.36, 95% CI: 0.10-1.33, = .13), while the use of electroconvulsive therapy (ECT) significantly increased the risk of hypersalivation (adjusted OR: 5.40, 95% CI: 1.22-24.02, = .03). Other variables, including age, Body Mass Index (BMI), smoking status, alcohol consumption, clozapine dosage, and use of anticholinergics, were not significantly associated with hypersalivation. The prevalence of hypersalivation in schizophrenia inpatients treated with clozapine was 14.6%. Male sex was associated with a reduced risk of hypersalivation, while ECT use significantly increased the risk. These findings provide valuable insights for clinicians managing patients on clozapine, highlighting the need for careful monitoring, particularly in patients undergoing ECT.
唾液分泌过多，即唾液产生和分泌过量，可能由相关疾病或药物不良反应引起。它会对身体健康、心理社会幸福感和生活质量产生重大影响。氯氮平是治疗难治性精神分裂症的金标准药物，但已知会导致部分患者唾液分泌过多。本研究旨在确定接受氯氮平治疗的精神分裂症患者中唾液分泌过多的患病率，并找出与其发生相关的因素，这些患者接受的治疗方式为单药治疗或与其他抗精神病药物联合使用。这项回顾性队列研究使用了一家三级精神病医院中被诊断为精神分裂症的住院患者的病历。数据收集自2020年6月1日至2020年12月31日期间接受氯氮平治疗的患者。描述性统计用于描述唾液分泌过多的患病率，并进行多因素逻辑回归以评估唾液分泌过多与患者特征之间的关联。共有96名患者纳入研究，平均年龄为44.03岁（标准差=13.27）；72.9%的患者为男性。唾液分泌过多的总体患病率为14.6%，接受氯氮平单药治疗的患者中有19.51%出现唾液分泌过多，接受氯氮平与其他抗精神病药物联合治疗的患者中有10.91%出现唾液分泌过多。男性似乎降低了唾液分泌过多的风险（调整后的比值比：0.36，95%置信区间：0.10-1.33，P=0.13），而使用电休克治疗（ECT）显著增加了唾液分泌过多的风险（调整后的比值比：5.40，95%置信区间：1.22-24.02，P=0.03）。其他变量，包括年龄、体重指数（BMI）、吸烟状况、饮酒情况、氯氮平剂量以及抗胆碱能药物的使用，与唾液分泌过多均无显著关联。接受氯氮平治疗的精神分裂症住院患者中唾液分泌过多的患病率为14.6%。男性与唾液分泌过多风险降低相关，而使用ECT则显著增加了该风险。这些发现为管理接受氯氮平治疗的患者的临床医生提供了有价值的见解，强调了仔细监测的必要性，尤其是在接受ECT治疗的患者中。
