PDF(Pubmed)
Abstract：
UNASSIGNED: Among antipsychotics, sialorrhea is most associated with clozapine, and when it occurs, it is uncomfortable, socially stigmatizing, and can contribute to medication non-adherence. Risperidone has a generally negligible muscarinic activity compared to clozapine, and yet, multiple reports of severe sialorrhea associated with risperidone have been reported.
UNASSIGNED: This case report describes risperidone-induced sialorrhea that was unintentionally masked by simultaneous clonidine administration that was intended to treat hypertension. Interestingly, sialorrhea was present but mild when clonidine was present; however, when risperidone was further titrated and clonidine removed, a significant worsening of sialorrhea developed. Sialorrhea did not respond to treatment with anticholinergic medication.
UNASSIGNED: The pathophysiology of antipsychotic-induced sialorrhea is complex and varies between antipsychotics. Risperidone-induced sialorrhea is suspected of having prominent adrenergic pathophysiology that is likely composed of highly viscoelastic saliva (high protein content), differing from the more commonly encountered clozapine-induced sialorrhea. Risperidone-induced sialorrhea is reported as more likely to respond to dose reduction and treatment with α2-adrenergic receptor agonists or β-adrenergic receptor antagonists and less likely to respond to anticholinergic (antimuscarinic) medications.
UNASSIGNED: This case report describes risperidone-induced sialorrhea that was unintentionally masked by simultaneous clonidine administration that was intended to treat hypertension. Interestingly, sialorrhea was present but mild when clonidine was present; however, when risperidone was further titrated and clonidine removed, a significant worsening of sialorrhea developed. Sialorrhea did not respond to treatment with anticholinergic medication.
UNASSIGNED: The pathophysiology of antipsychotic-induced sialorrhea is complex and varies between antipsychotics. Risperidone-induced sialorrhea is suspected of having prominent adrenergic pathophysiology that is likely composed of highly viscoelastic saliva (high protein content), differing from the more commonly encountered clozapine-induced sialorrhea. Risperidone-induced sialorrhea is reported as more likely to respond to dose reduction and treatment with α2-adrenergic receptor agonists or β-adrenergic receptor antagonists and less likely to respond to anticholinergic (antimuscarinic) medications.
摘要：
■在抗精神病药物中，流涎与氯氮平最相关，当它发生时，不舒服,社会污名化，并可能导致药物不依从性。与氯氮平相比，利培酮的毒蕈碱活性通常可忽略不计，然而，已有多例与利培酮相关的严重流涕报告.
■本病例报告描述了利培酮诱导的唾液溢，其被旨在治疗高血压的同时服用可乐定无意掩盖。有趣的是,存在唾液溢，但当可乐定存在时轻微；然而，当利培酮进一步滴定并去除可乐定时，出现明显的流涕恶化。鼻漏对抗胆碱能药物治疗无反应。
■抗精神病药引起的流涕的病理生理学是复杂的，并且在抗精神病药之间有所不同。怀疑利培酮诱导的鼻漏具有突出的肾上腺素能病理生理学，可能由高粘弹性唾液（高蛋白质含量）组成，与更常见的氯氮平引起的流涎不同。据报道，利培酮诱导的流涕更有可能对剂量减少和α2-肾上腺素能受体激动剂或β-肾上腺素能受体拮抗剂治疗产生反应，而对抗胆碱能（抗毒蕈碱）药物的反应较小。
■本病例报告描述了利培酮诱导的唾液溢，其被旨在治疗高血压的同时服用可乐定无意掩盖。有趣的是,存在唾液溢，但当可乐定存在时轻微；然而，当利培酮进一步滴定并去除可乐定时，出现明显的流涕恶化。鼻漏对抗胆碱能药物治疗无反应。
■抗精神病药引起的流涕的病理生理学是复杂的，并且在抗精神病药之间有所不同。怀疑利培酮诱导的鼻漏具有突出的肾上腺素能病理生理学，可能由高粘弹性唾液（高蛋白质含量）组成，与更常见的氯氮平引起的流涎不同。据报道，利培酮诱导的流涕更有可能对剂量减少和α2-肾上腺素能受体激动剂或β-肾上腺素能受体拮抗剂治疗产生反应，而对抗胆碱能（抗毒蕈碱）药物的反应较小。
