title: Sublingual atropine for sialorrhea secondary to parkinsonism: a pilot study.
abstract: Sialorrhea is a relatively common symptom in idiopathic Parkinson's disease and related conditions for which most of the accepted treatments are either highly invasive or may cause substantial systemic side effects. This study describes an open-label pilot study of sublingual atropine drops for the treatment of sialorrhea in 7 patients (6 with Parkinson's disease, 1 with progressive supranuclear palsy). Participants demonstrated statistically significant declines in saliva production, both objectively and subjectively. Self-reported drooling severity showed a significant decline between baseline and 180 minutes, t(6) = 3.240 P < 0.025 (eta(2) = 0.636), and between baseline and 1 week, t(6) = 4.583 P < 0.005 (eta(2) = 0.778). Objectively measured saliva production decreased significantly between baseline and the 1-week follow-up, t(6) = 2.711 P < 0.05 (eta(2) = 0.551). Delirium occurred in 1 patient (concurrent with a urinary tract infection), and 2 patients experienced worsening of hallucinations (active hallucinosis was concealed by both individuals to allow participation in the trial). The remaining trial participants did not experience any anticholinergic side effects. This trial shows that, in selected patient populations, sublingual atropine is a simple and inexpensive treatment for sialorrhea associated with parkinsonism.
authors.affiliation: Movement Disorders Program, London Health Sciences Centre, London, Ontario, Canada.
authors.forename: H Christopher
authors.initials: HC
authors.lastname: Hyson
authors.forename: Andrew M
authors.initials: AM
authors.lastname: Johnson
authors.forename: Mandar S
authors.initials: MS
authors.lastname: Jog
mesh_terms: D000286:Administration, Sublingual; D000368:Aged; D000369:Aged, 80 and over; D001285:Atropine / Q000008:administration & dosage* / Q000009:adverse effects; D003702:Delusions / Q000139:chemically induced; D005260:Female; D006212:Hallucinations / Q000139:chemically induced; D006801:Humans; D008297:Male; D008875:Middle Aged; D020734:Parkinsonian Disorders / Q000188:drug therapy*; D010865:Pilot Projects; D012472:Salivation / Q000187:drug effects; D012798:Sialorrhea / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D001285:Atropine