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How long does it take to get used to clozapine sedation/drool?


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Drooling can possibly be attenuated with anticholinergics. Clozapine does this by acting as a muscarinic acetylcholine receptor agonist at M4 receptors and its activemetabolite, N-desmethylclozapine, an agonist at M1 receptors. Glycopyrrolate is usually the anticholinergic of choice for this application as it doesn't cross into the central nervous system like most others, it is preferentially a peripherally-acting anticholinergic. Other anticholinergics that may be used (that may have more side effects) are hyocyamine, benztropine, oxybutynin, and trihexyphenidyl, possibly dicyclomine.

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On 6/10/2020 at 5:31 PM, aura said:

I've been on clozapine for a year and a half and I'm still drooling. There is some kind of medication you can take but it gave me tachycardia. I just accept it. Better off with than without.

Anticholinergics can do that, unfortunately... 😕 Glycopyrrolate is no exception (though less likely).

On 6/10/2020 at 5:29 PM, psychwardjesus said:

I've also seen 1% atropine eye drops sublingual used for clozapine-induced sialorrhea. Couldn't tell you if one is more effective than the other though. 

Atropine will definitely easily put you into an arrhythmia such as tachycardia though. It's used in emergency medicine as a drug to increase the heart rate in bradycardia.

Edited by mikl_pls
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