Sulpiride addition for the treatment of clozapine-induced hypersalivation: preliminary study.

BACKGROUND: Hypersalivation is a common, troublesome side effect of clozapine treatment. It occurs in 31-54% of clozapine treated patients. Management of this stigmatizing side effect may reduce noncompliance. Reports in the literature have shown beneficial clinical effects of combined clozapine-sulpiride therapy as measured by the Brief Psychiatric Rating Scale, and we found that this treatment combination also has very strong antisalivatory activity for clozapine-induced hypersalivation. METHODS: 18 patients (12 female, 6 male) with clozapine-induced hypersalivation received sulpiride (150-300 mg/day) in addition to ongoing clozapine treatment (from 100 mg/d to 800 mg/d). Baseline, 7 day and 21 day follow-up values were recorded for the 5-point Nocturnal Hypersalivation Rating Scale. RESULTS: At the end of the trial only 3 patients complained of minimal sialorrhea, and the mean Nocturnal Hypersalivation Rating Scale scale values showed a significant reduction in sialorrhea (delta baseline-endpoint -.2.78 +/- 0.87). CONCLUSIONS: Our findings support reports of the beneficial effect of clozapine-sulpiride combination therapy and suggest that sulpiride addition may contribute to the amelioration of clozapine-induced hypersalivation.

Evacuation of a mental health center during a forest fire in Israel.

Tirat Carmel Mental Health Center was successfully evacuated in December 2010 during a ravaging forest fire in the nearby Carmel Mountains. A total of 228 patients were successfully evacuated from the center within 45 minutes. No fatalities or injuries associated with the evacuation occurred. We believe that the efficient functioning of the administrative and medical staff provides a replicable model that can contribute to the level of awareness and readiness of hospital staff members for natural and manmade disasters.