Session Information
Date: Monday, September 23, 2019
Session Title: Clinical Trials, Pharmacology and Treatment
Session Time: 1:45pm-3:15pm
Location: Agora 3 West, Level 3
Objective: Evaluating effectiveness of sublingual Atropine 1% ophthalmic solution for treatment of sialorrhea in Parkinson’s disease.
Background: Sialorrhea is common non-motor symptom of Parkinson’s disease. The treatments for sialorrhea vary based on patient assessment, insurance, tolerability, and cognition. When oral stimulation through chewing gum to promote improved management of fluids fails, oral medications such as glycopyrrolate can be prescribed. Botulinum toxin (BoNT) injections are another therapy option and have shown success in improving sialorrhea. An off-label treatment may be utilized. Atropine 1% ophthalmic solution is indicated for end of life secretions; however, may be tolerated and effective in treatment for sialorrhea in patients who do not tolerate other therapies.
Method: Case Series. Three patient assessments and evaluation.
Results: Three patients were prescribed Atropine 1% ophthalmic solution to use Q4 hours for treatment of sialorrhea in setting of Parkinson’s disease. One of the three patients had previously tried botulinum toxin injections and was no longer interested in this therapy due to lack of benefit. One of the three patients had previously tried glycopyrrolate with side effects. One patient was not a candidate for glycopyrrolate due to cognitive changes. At follow up evaluation post Atropine treatment, three out of three patients reported a benefit in sialorrhea management. No patients reported side effects.
Conclusion: These case series suggest 1) Atropine 1% ophthalmic drops are an effective treatment when used sublingually for sialorrhea in PD, 2) Consider the indications for use of Atropine ophthalmic solution to be revised to include sialorrhea so that patients may obtain more easily via insurance, 3) Atropine drops may provide significant benefit for treatment of sialorrhea without producing side effects seen with oral medications.
To cite this abstract in AMA style:
K. Papesh, J. Nguyen. Atropine as Alternate Therapy for Treatment of Sialorrhea in Parksinson’s Disease [abstract]. Mov Disord. 2019; 34 (suppl 2). https://www.mdsabstracts.org/abstract/atropine-as-alternate-therapy-for-treatment-of-sialorrhea-in-parksinsons-disease/. Accessed June 14, 2025.« Back to 2019 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/atropine-as-alternate-therapy-for-treatment-of-sialorrhea-in-parksinsons-disease/