{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T06:00:58Z","timestamp":1787032858503,"version":"build-2736575974"},"reference-count":7,"publisher":"American Association of Psychiatric Pharmacists (AAPP)","issue":"4","license":[{"start":{"date-parts":[[2023,8,7]],"date-time":"2023-08-07T00:00:00Z","timestamp":1691366400000},"content-version":"vor","delay-in-days":6,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/3.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,8,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Clozapine can be associated with significant side effects and tolerability issues. Hyperhidrosis occurs less commonly and is unanticipated by clinicians because of clozapine's significant anticholinergic activity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case Report<\/jats:title>\n                    <jats:p>A 34-year-old female developed clozapine-induced nocturnal, generalized hyperhidrosis following initial titration to 400 mg\/day. Dose reduction did not decrease the side effect. Treatment with an anticholinergic medication could not be initiated because of constipation. Treatment with a beta blocker resulted in worsening of asthma. Treatment with a calcium channel blocker, diltiazem CD 180 mg\/day, resulted in a significant reduction in hyperhidrosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This case supports the use of calcium channel blockers to reduce clozapine-induced hyperhidrosis and offers an alternative to anticholinergic medications that may negatively impact clozapine tolerability.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.9740\/mhc.2023.08.193","type":"journal-article","created":{"date-parts":[[2023,8,7]],"date-time":"2023-08-07T13:10:24Z","timestamp":1691413824000},"page":"193-195","source":"Crossref","is-referenced-by-count":1,"title":["Diltiazem for clozapine-induced generalized hyperhidrosis"],"prefix":"10.9740","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1706-0432","authenticated-orcid":true,"given":"Emma M.","family":"Kenton","sequence":"first","affiliation":[{"name":"1 PharmD, University of Missouri-Kansas City School of Pharmacy, Kansas City, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1717-435X","authenticated-orcid":true,"given":"Samantha M.","family":"Zoellner","sequence":"additional","affiliation":[{"name":"2 PharmD Candidate, University of Missouri-Kansas City School of Pharmacy, Kansas City, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1481-8682","authenticated-orcid":true,"given":"Leigh Anne","family":"Nelson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"4719","published-online":{"date-parts":[[2023,8,7]]},"reference":[{"key":"2023080806202081000_i2168-9709-13-4-193-b01","volume-title":"Novartis Pharmaceutical Corporation;","author":"Clozaril [package insert]","year":"2021"},{"issue":"(6)","key":"2023080806202081000_i2168-9709-13-4-193-b02","doi-asserted-by":"crossref","first-page":"565","DOI":"10.1097\/JCP.0000000000001606","article-title":"The modernization of clozapine","volume":"42","author":"Leung","year":"2022","journal-title":"J Clin Psychopharmacol"},{"issue":"(3)","key":"2023080806202081000_i2168-9709-13-4-193-b03","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1016\/0163-7258(93)90027-B","article-title":"Muscarinic receptors\u2014Characterization, coupling and function","volume":"58","author":"Caulfield","year":"1993","journal-title":"Pharmacol Ther"},{"issue":"(3)","key":"2023080806202081000_i2168-9709-13-4-193-b04","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1016\/S0893-133X(98)00048-7","article-title":"Mixed agonist-antagonist properties of clozapine at different human cloned muscarinic receptor subtypes expressed in Chinese hamster ovary cells","volume":"20","author":"Olianas","year":"1999","journal-title":"Neuropsychopharmacology"},{"issue":"(8)","key":"2023080806202081000_i2168-9709-13-4-193-b05","doi-asserted-by":"crossref","first-page":"1329","DOI":"10.1176\/appi.ajp.158.8.1329-a","article-title":"Biperiden for excessive sweating from clozapine","volume":"158","author":"Richardson","year":"2001","journal-title":"Am J Psychiatry"},{"issue":"(3)","key":"2023080806202081000_i2168-9709-13-4-193-b06","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1113\/EP085639","article-title":"Impact of calcium regulation on eccrine sweating and sweating disorders: the view from cells to glands to intact human skin","volume":"101","author":"Metzler-Wilson","year":"2016","journal-title":"Exp Physiol"},{"issue":"(3)","key":"2023080806202081000_i2168-9709-13-4-193-b07","doi-asserted-by":"crossref","first-page":"669","DOI":"10.1016\/j.jaad.2018.11.066","article-title":"The etiology, diagnosis, and management of hyperhidrosis: A comprehensive review: Therapeutic options","volume":"81","author":"Nawrocki","year":"2019","journal-title":"J Am Acad Dermatol"}],"container-title":["Mental Health Clinician"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/meridian.allenpress.com\/mhc\/article-pdf\/13\/4\/193\/3245728\/i2168-9709-13-4-193.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/meridian.allenpress.com\/mhc\/article-pdf\/13\/4\/193\/3245728\/i2168-9709-13-4-193.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,15]],"date-time":"2024-11-15T11:24:00Z","timestamp":1731669840000},"score":1,"resource":{"primary":{"URL":"https:\/\/mhc.kglmeridian.com\/view\/journals\/mhcl\/13\/4\/article-p193.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,8,1]]},"references-count":7,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2023,8,7]]},"published-print":{"date-parts":[[2023,8,1]]}},"URL":"https:\/\/doi.org\/10.9740\/mhc.2023.08.193","relation":{},"ISSN":["2168-9709"],"issn-type":[{"value":"2168-9709","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,8,1]]}}}