Transdermal Scopolamine and Sialorrhea

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Abstract
To the Editor. —Atropine is often used to diminish salivation in patients with sialorrhea or difficulty handling salivary secretions because of disorders of swallowing. The related muscarinic antagonist scopolamine is known to have a more potent action on the salivary glands.1 However, undesirable side effects associated with high peak serum levels following oral administration have precluded its use. The availability of scopolamine in a transdermal delivery system provides an alternative means to administer the antisialogogue and may have advantages over oral atropine for some patients. When applied to the skin, the system releases scopolamine at a constant rate to maintain a steady plasma level (after an initial delay of two to four hours). A 57-year-old woman with a two-year history of amyotrophic lateral sclerosis encountered difficulty with drooling due to bulbar weakness. Placement of a scopolamine transdermal delivery system (Transderm-Scop, CIBA Pharmaceutical Co, Summit, NJ) in the postauricular area

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