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Treatment of unintentional drooling of saliva in motor neuron disease

Unintentional drooling of saliva (sialorrhea) is a distressing symptom suffered by up to 25% of patients with motor neuron disease. The management of sialorrhea currently involves the use of suction, drug treatments and more invasive approaches, including injection of botulinum toxin to the salivary glands, radiotherapy to the salivary glands and ligation (surgery to tie off) of the salivary gland ducts.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

Interventions for drooling in children with cerebral palsy

Many children with CP have difficulty controlling saliva. Drooling varies in severity and can be distressing for the children, families and caregivers. Excessive drooling can cause constant damp soiled clothing, unpleasant odour, irritated, chapped or sore skin around the mouth and chin, skin and mouth infections, dehydration, difficulties chewing, interference with speech, damage to books, communication aids, computer and audio equipment. There is also risk of social rejection and social isolation for these children.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Interventions for people with schizophrenia who have too much saliva due to clozapine treatment

Clozapine is an antipsychotic medication used in the treatment of schizophrenia, a mental health problem that can cause symptoms such as hallucinations and delusions and social withdrawal. Clozapine may be useful in those for whom other medications have not worked very well. One of the common side‐effects of clozapine is having too much saliva in the mouth (hypersalivation). This can be embarrassing in public and problematic, especially at night. This review is about ways of reducing this problem and includes 15 trials containing 964 people, most of which were done in hospitals in China. Treatments included medications that had previously been useful for this problem or were thought to work in theory. The medications used were from a group of drugs called antimuscarinics, traditional Chinese medicines or others. The trials were short (all four weeks or less). From these trials the antimuscarinics; astemizole, diphenhydramine and propantheline, were shown to be better than placebo at reducing hypersalivation. Another medication called oryzanol and a Chinese traditional medicine called Suo quo wan were found to have benefit over doxepin, an antimuscarinic. However, because of the shortness of the trials, poor reporting and the limitations of design, it is difficult to draw any firm conclusions from these results. 

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Managing symptoms in motor neuron disease

Motor neuron disease (MND), which is also known as amyotrophic lateral sclerosis (ALS), is an uncommon, incurable disease that affects the nerves involved in movement. MND gets worse over time and affects muscles of the limbs, speech, swallowing and breathing. People with MND experience a wide range of symptoms, including a number of physical ability limitations, pain, spasticity, cramps, swallowing problems and difficulty breathing. It is important to recognise that clinical trials may fail to show that a treatment is effective for several reasons that are not related to the effects of the treatment itself, for example when there are too few people in a trial, or investigators choose an ineffective dose of a drug.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2017

Anticholinergic medication for excessive salivation caused by use of antipsychotics other than clozapine

The first line of treatment of schizophrenia is usually antipsychotic drugs. These drugs help in the treatment of the ‘positive symptoms’ of schizophrenia, such as hearing voices, seeing things and having strange beliefs. However, these drugs often have serious side effects, such as weight gain, muscle stiffness, tiredness, apathy and lack of drive. Dribbling or drooling (hypersalivation) is another common side effect, which frequently occurs at night when asleep. This can be an embarrassing and stigmatising problem that can affect quality of life and cause people to stop their medication, which may result in relapse and going back into hospital. Dribbling and drooling can be difficult to treat; however, anticholinergic drugs can decrease production of saliva and dribbling. This review assessed the evidence for the benefit or harm of anticholinergic drugs used in treating hypersalivation caused by antipsychotic or neuroleptic medication. The review excluded the antipsychotic clozapine, as its role in causing hypersalivation has been the subject of another Cochrane review.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Aripiprazole for autism spectrum disorders (ASD)

Aripirazole is an antipsychotic drug ‐ a type of medication used to treat serious mental disorders such as paranoia. It has also been used to treat behavioural problems (e.g. aggression, severe temper tantrums) in people with autism spectrum disorders (ASD). Aripiprazole has been shown to be well tolerated and to improve behavioural problems in other disorders such as schizophrenia and bipolar disorder. As aripiprazole is a relatively new drug, it is important to understand both the benefits and side effects of this drug in patients with ASD.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2016

Treating Disruptive Behavior Disorders in Children and Teens: A Review of the Research for Parents and Caregivers

This summary will answer these questions: What are disruptive behavior disorders (DBDs)? How are DBDs treated? » Psychosocial treatment (treatment with a trained therapist) » Medicines What have researchers found about treatments for DBDs? What are possible side effects of medicines for DBDs? What should I talk about with my child's or teen's health care professional?

Comparative Effectiveness Review Summary Guides for Consumers [Internet] - Agency for Healthcare Research and Quality (US).

Version: August 31, 2016

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