Clonidine Treatment of Clozapine-Induced Hypersalivation

Clozapine 투여로 인한 타액 과잉분비에 대한 Clonidine의 치료효과

Background : Hypersalivation can be a troublesome side effect of clozapine, limiting its usefulness in the management of some cases of schizophrenia. But the pharmacodynamic basis of clozapine-induced hypersalivation remains obscure. Object : The aim of this study was to evaluate the effect of the ${\alpha}_2$-adrenergic agonist clonidine on clozapine-induced hypersalivation in the patients who were receiving clozapine. Method : Twenty one schizophrenic inpatients on clozapine participated in the study. The amount of saliva was measured on the 7th day at 8pm after starting clozapine treatment. Of them, 15 patients who had experienced hypersalivation was treated with 0.1mg/day of clonidine. Result : Of 21 schizophrenic patients treated with clozapine in the psychiatric inpatient clinic, 15(71.4%) complained hypervalivation. After clonidine treatment, mean salivary flow-rate was decreased significantly in these patients. Conclusion : Clozapine-induced hypersalivation could be decreased by administration of ${\alpha}_2$-adrenergic agonist clonidine and compliance could be improved. Also our study supports the notion that increased adrenergic tone contributes to clozapine-induced hypersalivation.

Clozapine의 부작용 중 타액의 과잉분비의 원인을 알아보기 위하여 순천향대학교 천안병원 신경정신과에 입원한 환자 중 정신분열병 환자 21명(남자 12명, 여자 9명)을 대상으로 시행한 본 연구결과는 다음과 같다. 1) 정신분열병 환자에게 clozapine을 투여한 후 타액의 분비는 유의하게 증가하였다. 2) Clozapine을 투여한 후 타액의 과잉분비를 보인 정신분열병 환자에게 clonidine을 투여한 후 타액의 분비는 유의하게 감소하였다. 3) Clozapine에 의한 타액의 과잉분비는 ${\alpha}$-아드레날린성 작용에 의한다는 것을 강하게 시사한다.