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Therapie der Clozapin-induzierten Hypersalivation mit Botulinum-Toxin B

Pharmacological strategies for clozapine-induced hypersalivation: treatment with botulinum toxin B in one patient and review of the literature

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Zusammenfassung

Hypersalivation ist eine häufige unerwünschte Nebenwirkung einer Behandlung mit Clozapin. Bisherige therapeutische Strategien zur Reduktion von Sialorrhö zielten auf die Gabe antimuskarinerger (anticholinerger) und α2-agonistischer Substanzen. Die Verwendung dieser Substanzen ist aber limitiert durch deren teilweise mangelnde Wirksamkeit und durch ein ungünstiges Nebenwirkungsprofil. Eine neue und sichere Therapieoption der Clozapin-induzierten Hypersalivation ergibt sich durch die Injektion von Botulinum-Toxin. Im Folgenden beschreiben wir einen Patienten, bei dem Botulinum-Toxin B zur Reduktion von Hypersalivation eingesetzt wurde und geben eine Übersicht über bisherige Therapiestrategien zur Reduktion von Clozapin-induzierter Hypersalivation.

Summary

Hypersalivation is frequently observed in patients treated with clozapine. Current strategies to counteract sialorrhea include the introduction of antimuscarinergic (anticholinergic) and α2-agonistic treatment. However, the use of these substances is limited in part by lack of efficacy and by adverse side effects. In cases of intractable sialorrhea, the application of botulinum toxin may be a new and safe therapeutic option. We here present an overview on current treatment strategies for sialorrhea and describe a patient who received botulinum toxin B for clozapine-induced hypersalivation.

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Authors and Affiliations

  1. Klinik für Psychiatrie und Psychotherapie, Universität Lübeck

    K. G. Kahl, A. Kordon & R. Lencer

  2. Klinik für Neurologie, Universität Lübeck

    P. Trillenberg, C. Klein & J. Hagenah

  3. Klinik für Psychiatrie und Psychotherapie, Ratzeburger Allee 160, 23538, Lübeck, Deutschland

    K. G. Kahl

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  1. K. G. Kahl
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  2. P. Trillenberg
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  3. A. Kordon
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  4. R. Lencer
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  5. C. Klein
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  6. J. Hagenah
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Correspondence to K. G. Kahl.

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Kahl, K.G., Trillenberg, P., Kordon, A. et al. Therapie der Clozapin-induzierten Hypersalivation mit Botulinum-Toxin B . Nervenarzt 76, 205–208 (2005). https://doi.org/10.1007/s00115-004-1800-x

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  • DOI: https://doi.org/10.1007/s00115-004-1800-x

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