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Ching-Yi Feng1 Yi-Chia Huang2*
1Department of Traditional Chinese Medicine, Kaohsiung Veterans General Hospital Tainan
Branch, Tainan, Taiwan
2Department of Chinese Medicine, Tri-Service General Hospital, Taipei, Taiwan
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Clozapine is one of the second-generation antipsychotics (SGA) for schizophrenia. However, the use of Clozapine is limited due to the side effect of hypersalivation, which may result in aspiration pneumonia. In Western medicine, Clozapine induced hypersalivation is considered to be related to increase in saliva output or decrease in swallow reflex. Although some anticholinergic agents or alpha 2 agonists were applied to the treatment, there are currently insufficient data to confidently validate this clinical practice.
In Chinese medicine, saliva is one of the “five humors”. Production of fluid and humor in the human body is related to the “five viscera”. Moreover, hypersalivation is mainly related to spleen, stomach, and kidney. As we think Clozapine is a bitter and cold drug, use of Clozapine causes “stomach cold and spleen heat pattern”, and “kidney deficiency pattern” if case of long-term use. For Clozapine-using patients, the solution lies in the use of traditional Chinese medicine as adjuvant therapy. At first, treatment policy include warming the stomach, directing qi downward and enriching spleen yin; then we can add drugs to tonify the kidney if need be. If dampness-heat is noted, we can treat the patient
under the principle of “draining dampness and clearing heat”, as well as “warming the middle and resolving phlegm”.
Keywords：Clozapine, Hypersalivation, Chinese medicine treatment
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202.7 Clozapine 引起過度流涎中西醫病機與治療的文獻回顧
