Sublingual atropine drops for effective management of pediatric sialorrhea

Summaries 1 min 99

Font Size

Created On: 12/03/2026

Excessive drooling, medically called as sialorrhea, is a common challenge in children with neurodevelopmental disorders.

See All

Key take away

Children with neurodevelopmental disorders experience significant improvement in drooling after sublingual atropine therapy.

Background

Excessive drooling, medically called as sialorrhea, is a common challenge in children with neurodevelopmental disorders. Beyond social and emotional concerns, uncontrolled drooling can elicit serious health complications such as aspiration pneumonia, skin irritation, dental damage, and secondary infections. This single-center, retrospective study explored the efficacy and safety of sublingual atropine drops for mitigating sialorrhea in a pediatric population attending a multidisciplinary sialorrhea clinic.

Method

Patient demographics, comorbidities, clinical characteristics, prior treatments, quality of life outcomes, and medication side effects were collected. Drooling frequency and severity scale (DFSS) scores were analyzed to check drooling severity before and after atropine therapy. Descriptive statistics were used to examine treatment outcomes, and Wilcoxon signed-rank tests determined pre- and post-intervention DFSS scores.

Result

A total of 32 pediatric patients (mean age at presentation was 9.4 years) received sublingual atropine, with 21 meeting study criteria. Most patients had neurodevelopmental disabilities and required mobility support. Prior treatments included medication (24%) and botulinum toxin injections (23.8%). Median DFSS scores dropped from 4 to 3 for both drooling frequency and severity following atropine therapy, indicating a statistically and clinically significant improvement. Sublingual atropine was well-tolerated, with 71% of patients reporting no side effects. Reported adverse effects were unpleasant taste (9.6%), constipation (9.5%), facial flushing (4.8%), and behavioral changes (4.8%).

Conclusion

Sublingual atropine proved to be a safe and effective treatment for pediatric sialorrhea, yielding remarkable improvement in drooling frequency and severity among children with neurodevelopmental disorders. These outcomes support its use as a practical option in multidisciplinary pediatric care settings.