Glycopyrrolate for treatment of clozapine-induced sialorrhea in three adolescents

Department of Psychiatry and Behavioral Sciences, Children's National Medical Center, 111 Michigan Avenue NW, Washington, D.C., USA.
Journal of Child and Adolescent Psychopharmacology (Impact Factor: 3.07). 03/2008; 18(1):99-107. DOI: 10.1089/cap.2007.0037
Source: PubMed

ABSTRACT The aim of this case study was to report preliminary data on the effectiveness and tolerability of glycopyrrolate for the treatment of clozapine-induced sialorrhea, or excessive flow of saliva, in an adolescent population.
Three adolescent females (age 13-16), who developed sialorrhea secondary to clozapine treatment, received an open-label trial of glycopyrrolate (4-8 mg) during inpatient hospitalization for treatment-resistant psychotic illness.
The target symptom of sialorrhea was improved in all three cases, with patient self-reports of decreased production of saliva confirmed by staff observation. Glycopyrrolate was generally well tolerated by the patients. One patient reported constipation, which improved with symptomatic treatment. A second patient reported dry mouth, which improved with a reduction in dose of glycopyrrolate.
These three cases provide support for the potential effectiveness and tolerability of glycopyrrolate for clozapine-induced sialorrhea in adolescents. Further controlled studies are required to determine the safety, efficacy and tolerability of glycopyrrolate in this age group and in adults for clozapine-induced sialorrhea.

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