Sublingual administration of atropine eyedrops in children with excessive drooling - a pilot study.

Johanna Norderyd,Eva Sjöstrand,Agneta Marcusson,Gunilla Steinwall,Jonas Graf,Mats Bågesund,Elinor Ärleskog,Karolina Nilsson

doi:10.1111/ipd.12219

Abstract

BackgroundDrooling can be a severe disability and have high impact on daily life. Reversible treatment is preferable.AimTo analyse whether sublingual administration of atropine eyedrops is a useful reversible treatment option for severe drooling in children with disabilities.DesignThe study had a prospective, single‐system research design. The participants served as their own controls. The study period was 3 weeks without treatment, 4 weeks with atropine eyedrop solution 10 mg/mL one drop a day followed by 4 weeks of one drop twice a day. Parents’ rating of their child's drooling was assessed on a 100‐mm VAS, and unstimulated salivary secretion rate measurement was performed together with notations about side effects and practicality.ResultsParents’ VAS assessment of drooling decreased from a median (range) of 74 (40–98) at baseline to 48 (18–88) (P = 0.05) and 32 (12–85) (P = 0.004) after 4 weeks of atropine once a day and another 4 weeks of atropine twice a day, respectively (n = 11). Unstimulated salivary secretion rates decreased from baseline to end of study (P = 0.032). Several parents complained about difficult administration. No irreversible side effects were noted.ConclusionsSublingual atropine eyedrops may be an alternative for treatment of severe drooling in children with disabilities.

Highlights

The aim of this study was to analyse whether the use of sublingually administered atropine eyedrops is a useful treatment option for the control of drooling in children with disabilities
Inclusion criteria were children belonging to group 1–2 according to the ASA (American Society of Anaesthesiologists) Physical Status Classification System[31] with no allergy to atropine eyedrops or other medical conditions contraindicating the use of atropine
Three left the study directly after the first visit and were considered dropouts together with another four who terminated their participation after finishing the period of one drop a day

Summary

Introduction

Drooling is considered to be a normal condition until the age of 3 years, commonly associated to the eruption of teeth[1]. After this age, drooling should cease in children with typical development. Drooling may lead to psycho-social and physical consequences and can be considered a severe disability in itself with high impact on daily life for the child and family[7]. Drooling can be a severe disability and have high impact on daily life. Aim. To analyse whether sublingual administration of atropine eyedrops is a useful reversible treatment option for severe drooling in children with disabilities. Parents’ rating of their child’s drooling was assessed on a 100-

Objectives

Methods

Results

Conclusion