Atropine for the treatment of paediatric sialorrhea: a retrospective case series

Objectives This retrospective case series examined the efficacy of sublingual atropine drops for paediatric patients with sialorrhea followed at the multidisciplinary sialorrhea clinic at Children's Hospital, London Health Sciences Centre. Methods A retrospective review of patients seen for management of sialorrhea at the multidisciplinary sialorrhea clinic between January 1, 2015 and September 30, 2023 was completed. Patient demographics, comorbidities, interventions, frequency and severity of sialorrhea, and adverse effects were recorded. Drooling frequency and severity scale (DFSS) scores were collected to examine the effectiveness of atropine sublingual drops. A descriptive analysis and Wilcox signed-rank tests were conducted to compare pre- and post-treatment DFSS scores. Results Twenty-one patients were included in the final analysis. The median DFSS score pretreatment was 4 for frequency and 4 for severity. Post-treatment, the median DFSS score decreased to 3 for both frequency (P = 0.006) and severity (P = 0.003), representing a statistically and clinically significant change. Conclusion Atropine sublingual drops demonstrated efficacy for decreasing both drooling frequency and severity in a paediatric patient population.