title: A randomized placebo-controlled trial of oxybutynin for the initial treatment of palmar and axillary hyperhidrosis.
abstract: BACKGROUND
  Video-assisted thoracic sympathectomy provides excellent resolution of palmar and axillary hyperhidrosis but is associated with compensatory hyperhidrosis. Low doses of oxybutynin, an anticholinergic medication that competitively antagonizes the muscarinic acetylcholine receptor, can be used to treat palmar hyperhidrosis with fewer side effects.
  
  
  OBJECTIVE
  This study evaluated the effectiveness and patient satisfaction of oral oxybutynin at low doses (5 mg twice daily) compared with placebo for treating palmar hyperhidrosis.
  
  
  METHODS
  This was prospective, randomized, and controlled study. From December 2010 to February 2011, 50 consecutive patients with palmar hyperhidrosis were treated with oxybutynin or placebo. Data were collected from 50 patients, but 5 (10.0%) were lost to follow-up. During the first week, patients received 2.5 mg of oxybutynin once daily in the evening. From days 8 to 21, they received 2.5 mg twice daily, and from day 22 to the end of week 6, they received 5 mg twice daily. All patients underwent two evaluations, before and after (6 weeks) the oxybutynin treatment, using a clinical questionnaire and a clinical protocol for quality of life.
  
  
  RESULTS
  Palmar and axillary hyperhidrosis improved in >70% of the patients, and 47.8% of those presented great improvement. Plantar hyperhidrosis improved in >90% of the patients. Most patients (65.2%) showed improvements in their quality of life. The side effects were minor, with dry mouth being the most frequent (47.8%).
  
  
  CONCLUSIONS
  Treatment of palmar and axillary hyperhidrosis with oxybutynin is a good initial alternative for treatment given that it presents good results and improves quality of life.
authors.affiliation: Division of Vascular Surgery, University of São Paulo Medical School, São Paulo, SP, Brazil. nwolosker@yahoo.com.br
authors.forename: Nelson
authors.initials: N
authors.lastname: Wolosker
authors.forename: José Ribas Milanez
authors.initials: JR
authors.lastname: de Campos
authors.forename: Paulo
authors.initials: P
authors.lastname: Kauffman
authors.forename: Pedro
authors.initials: P
authors.lastname: Puech-Leão
mesh_terms: D000293:Adolescent; D000328:Adult; D001938:Brazil; D016009:Chi-Square Distribution; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D006945:Hyperhidrosis / Q000188:drug therapy* / Q000503:physiopathology / Q000523:psychology; D008297:Male; D008333:Mandelic Acids / Q000008:administration & dosage* / Q000009:adverse effects; D008875:Middle Aged; D018727:Muscarinic Antagonists / Q000008:administration & dosage* / Q000009:adverse effects; D017060:Patient Satisfaction; D011446:Prospective Studies; D011788:Quality of Life; D011795:Surveys and Questionnaires; D013546:Sweating / Q000187:drug effects*; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D008333:Mandelic Acids; D018727:Muscarinic Antagonists; C005419:oxybutynin