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

Abstract

Background: Drooling can be a severe disability and have high impact on daily life. Reversible treatment is preferable. Aim: To analyse whether sublingual administration of atropine eyedrops is a useful reversible treatment option for severe drooling in children with disabilities. Design: The 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. Results: Parents’ 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. Conclusions: Sublingual atropine eyedrops may be an alternative for treatment of severe drooling in children with disabilities.