Clozapine has both anticholinergic, cholinergic actions. whats the mechanism?

[sujalneuro]

Clozapine has both anticholinergic, cholinergic actions.
whats the mechanism?

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[hamstergang]

Wikipedia says: "While clozapine is a muscarinic antagonist at the M1, M2, M3, and M5 receptors, clozapine is a full agonist at the M4 subset. Because M4 is highly expressed in the salivary gland, its M4 agonist activity is thought to be responsible for the hypersalivation."

 

[MacDonaldTriad]

Davydov L, Botts SR, Clozapine-induced hypersalivation. Ann Pharmacother. 2000;34(5):662-665.

Bai YM, Lin CC. Chen JY, et al. Theraputic effect of pirenzepine for clozapine-induced hypersalivation: a randomized, double-blind, placebo-controlled, cross over study. J Clin Psychopharmacol. 2001; 21(6):608-611.

Calderon J. Rubin E. Sobata WL. Potential use of ipratropium bromide for the treatment of clozapine-induced hypersalivation: a preliminary report. Int Clin Psychopharmacol. 2000;15(1);49-52.