GLYCOPYRROLATE FOR SIALORRHEA IN PARKINSON'S DISEASE
Neurology [2010] 74 (15) : 1203-1207 (Arbouw ME, Movig KL, Koopmann M, Poels
PJ, Guchelaar HJ, Egberts TC, Neef C, van Vugt JP) Complete abstract
Sialorrhea (excessive saliva) affects 3 out of every 4 people with
Parkinson's Disease. Sialorrhea is often treated with anticholinergics, but
side effects limit their usefulness. Glycopyrrolate (glycopyrronium bromide)
is an anticholinergic drug that is not able to cross the blood-brain barrier
in considerable amounts. Therefore, glycopyrrolate exhibits minimal central
nervous system side effects, which may be an advantage in people with
Parkinson's Disease. In a clinical trial the severity of the sialorrhea was
scored on a daily basis by the patients or a caregiver with a sialorrhea
scoring scale ranging from 1 (no sialorrhea) to 9 (profuse sialorrhea). Around
39% of people taking glycopyrrolate had a clinically relevant improvement of
at least 30%, without side effects. The authors concluded that 1 mg 3 times
daily is an effective and safe therapy for sialorrhea in Parkinson disease.
However, these results also mean that around 60% of people with Parkinson's
Disease do not significantly benefit from its use.
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