Drug-induced Sialorrhoea

Summary Sialorrhoea is a common adverse effect of a range of medicines, primarily clozapine. At least a third of patients treated with clozapine suffer from sialorrhoea, and the consequences of this can be socially stigmatising and lead to non-adherence. The treatment options are limited and primarily centered around muscarinic antagonism. We suggest non-pharmacological interventions followed by locally applied atropine or glycopyrrolate. If systemic treatment is necessary, amisulpride, benztropine, or terazosin may be attempted.