Botulinum toxin B as an effective and safe treatment for neuroleptic-induced sialorrhea.
BACKGROUND
Severe sialorrhea is a common, potentially stigmatizing and disabling side-effect of neuroleptic drugs such as clozapine. Sialorrhea also occurs in neurological disorders such as Parkinson's disease (PD). For neurological diseases, several studies have demonstrated botulinum toxin type B to be a safe and effective treatment.


OBJECTIVE
To evaluate the treatment effects, tolerance, and duration of treatment-induced effects of botulinum toxin type B (Neurobloc) in the context of neuroleptic-induced sialorrhea (group 1) or PD-associated drooling (group 2) in a double-blind, placebo-controlled trial.


METHODS
Nine patients (four from group 1; five from group 2) with severe sialorrhea received injections into the salivary glands with either botulinum toxin type B or placebo and were followed over 16 weeks.


RESULTS
We found large effect sizes for improvement of sialorrhea in patients treated with botulinum toxin type B, whereas the improvement of sialorrhea in those receiving placebo was only small. No patient reported any side effects. Reduction of sialorrhea lasted for 8 to 16 weeks after a single injection.


CONCLUSIONS
Like for PD, botulinum toxin type B represents an effective and safe treatment for neuroleptic-induced sialorrhea with a treatment effect of 8 to 16 weeks.
Steinlechner
Susanne
S
Department of Psychiatry and Psychotherapy, University of Luebeck, Ratzeburger Allee 160, 23538 Luebeck, Germany. susanne.steinlechner@psychiatrie.uk-sh.de
Klein
Christine
C
Moser
Andreas
A
Lencer
Rebekka
R
Hagenah
Johann
J
D000368:Aged; D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001905:Botulinum Toxins / Q000009:adverse effects / Q000627:therapeutic use*; D019274:Botulinum Toxins, Type A; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000150:complications; D012469:Salivary Glands / Q000378:metabolism; D012720:Severity of Illness Index; D012798:Sialorrhea / Q000139:chemically induced / Q000188:drug therapy* / Q000209:etiology; D013997:Time Factors
D014150:Antipsychotic Agents; C096323:rimabotulinumtoxinB; D001905:Botulinum Toxins; D019274:Botulinum Toxins, Type A