Is clonidine useful for treatment of clozapine-induced sialorrhea?

J Psychopharmacol. 2005 Jul;19(4):426-8. doi: 10.1177/0269881105053311.


Clozapine has shown superior efficacy in treatment of refractory schizophrenia, but its use is limited by emergent side-effects. Among other adverse effects, sialorrhea is a troublesome side-effect, its stigmatizing nature results in poor treatment compliance. Several hypotheses have been put forward in the etiology of clozapine-induced sialorrhea. 2 adrenergic antagonism is hypothesized to be involved in its pathophysiology, based on the response to clonidine and lofexidine. Oral clonidine (50 to 100 g/day) was tried on 12 stable outpatients of schizophrenia maintained on clozapine. Wet area over the pillow as reported by the patients was recorded at baseline and at 4 weeks of treatment along with the subjective response after the treatment. Most of the patients reported a decrease in sialorrhea without any adverse events. We describe encouraging results in an open case series of oral clonidine for clozapine-induced sialorrhea.

Publication types

  • Clinical Trial

MeSH terms

  • Adrenergic alpha-Agonists / therapeutic use*
  • Adult
  • Antipsychotic Agents / adverse effects*
  • Antipsychotic Agents / therapeutic use
  • Clonidine / therapeutic use*
  • Clozapine / adverse effects*
  • Clozapine / therapeutic use
  • Female
  • Humans
  • Male
  • Middle Aged
  • Schizophrenia / complications
  • Schizophrenia / drug therapy
  • Sialorrhea / chemically induced*
  • Sialorrhea / drug therapy*


  • Adrenergic alpha-Agonists
  • Antipsychotic Agents
  • Clozapine
  • Clonidine