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Metoclopramide may be effective for clozapine-induced hypersalivation
  1. Brian Hallahan
  1. National University of Ireland Galway, Galway, Ireland; brian.hallahan@nuigalway.ie

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ABSTRACT FROM: Kreinin A, Miodownik C, Mirkin V, et al. Double-blind randomized, placebo-controlled trial of metoclopramide for hypersalivation associated with clozapine. J Clin Psychopharmacol 2016;36:200–5.

What is already known on this topic

Clozapine-induced hypersalivation is the most prevalent adverse effect experienced by patients treated with clozapine and negatively impacts on quality of life,1 with symptoms particularly prevalent at night-time. Pharmacotherapeutic strategies employed to date, based on multiple mechanisms including antimuscarinic agents and α-2 agonists have largely been associated with, at most, a minimal therapeutic effect.2 The development of strategies would thus be welcomed given the lack of effective treatment options, with such strategies hopefully being associated with an improvement in clinical outcome and perhaps also long-term treatment adherence.

Methods of the study

A 3-week randomised double-blind trial of metoclopramide (n=30) compared with placebo (n=28) was conducted on inpatients between January 2012 and May 2014 at two government affiliated centres in Israel. Patients were predominantly men (n=48), with an age range between 19 and 64 years (mean age: 40 years) and had a chronic disease course (mean duration of illness: 18 years). All patients were treated …

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