Glycopyrrolate treatment of chronic drooling

P. A. Blasco and J. C. Stansbury
Gillette Children's Hospital, St Paul, Minn, USA.

OBJECTIVE: To describe the use of glycopyrrolate in the control of drooling in children and young adults with cerebral palsy and related neurodevelopmental disabilities. DESIGN: Prospective, open-label study of drug dosage parameters, response to therapy, and side effects. Follow-up ranged from 8 months to 4 years. SETTING: Outpatient clinic of a rehabilitation hospital that is a regional referral center for children with disabilities. PATIENTS: Forty children and young adults with motor and/or cognitive disabilities who were experiencing drooling to a severe degree. INTERVENTION: Treatment with oral glycopyrrolate. OUTCOME MEASURES: Change in the quantity of drooling and side effects associated with treatment. RESULTS: Thirty-six patients (90%) had reduced drooling in response to medication; 2 (5%) could not be assessed and 2 (5%) received no benefit. Side effects resulted in discontinuation of treatment in 11 (28%). Overall, 26 (65%) continued to receive drug therapy because of the perceived benefit. The final effective dose ranged widely from 0.01 to 0.82 mg/kg per day. CONCLUSIONS: Glycopyrrolate therapy safely and effectively decreased but rarely abolished drooling in patients with cerebral palsy and related neurodevelopmental disabilities. The dose range was surprisingly broad. Side effects, although generally minor and predictable, often led to discontinuation of drug therapy.

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