1981]. When assessed under the World Health Organization (WHO) causality categories, it qualified for category C2, i.e. ‘probable/likely’ [WHO, 2000]. This showed that clozapine is the probable or likely cause for parotid swelling in this case. Systematic review A systematic review was performed with the aim of finding evidence regarding the Inhibitors,research,lifescience,medical treatment of clozapine-induced parotid gland swellings. Five medical databases were searched (i.e. PubMed, PsycINFO, Embase, MEDLINE

and NHS Evidence – mental health). Articles in English up to March 2012 were considered. Search terms included: parotid, parotitis, salivary, swelling, ptyalism, Inhibitors,research,lifescience,medical hypersalivation, psychosis, schizophrenia, anticholinergic, antihistaminic, alpha 1 antagonist, treatment and other relevant terms. A total of 51 articles were identified by web-based searching in the first phase. After further manual scrutiny only 12 reports fulfilled the review criteria. All reports were http://www.selleckchem.com/products/Imatinib-Mesylate.html evaluated according to the Oxford

Centre of Evidence-based Medicine levels of evidence criteria. Two were Inhibitors,research,lifescience,medical classified as level B (retrospective cohort studies), five were case-series-based reports hence fulfilled level C, while five were case reports based on one case. The aim of most reports was to highlight the occurrence of salivary gland swelling in clozapine and reported spontaneous Inhibitors,research,lifescience,medical resolution or resolution by discontinuing clozapine. Three reports tried pharmacological options such as benzatropine and ipratropium with variable success. None of the reports identified a clear treatment regimen for clozapine-induced parotid gland swelling. Terazosin Terazosin, Inhibitors,research,lifescience,medical classified as a quinazoline, is similar to doxazosin and prazosin (see Figure 1). As an alpha-adrenergic blocking agent, terazosin is used to treat hypertension and benign prostatic hypertrophy (BPH) [Lieber, 1998]. It selectively and competitively

inhibits vascular postsynaptic alpha (1)-adrenergic receptors, resulting in peripheral vasodilatation and a reduction of vascular resistance and blood pressure. It is metabolized in the liver and one of the four metabolites (piperazine) has antihypertensive Dacomitinib activity. It is completely absorbed in man (90% bioavailability) and has a half-life of 12 h; toxicity LD50 = 259.3 mg/kg (intravenous in mice) Figure 1. Terazosin (C19H25N5O4). Benzatropine Benzatropine possesses both anticholinergic and antihistaminic effects. It is used as an adjunct in the therapy of all forms of Parkinsonism and also for use in the control of extrapyramidal disorders due to neuroleptic drugs [Lieber, 1998]. Benzatropine is a selective M1 muscarinic acetylcholine receptor antagonist acting selectively on central nervous system (CNS) receptors (see Figure 2).