From the Research
Hypersalivation is primarily caused by neurological disorders, medications, and physiological states, with the most recent and highest quality study suggesting that Parkinson's disease is a significant contributor to this condition. According to the study published in 2023 1, hypersalivation, or excessive saliva production, is a common symptom in patients with Parkinson's disease, affecting up to 56% of patients. Other medical conditions that can cause hypersalivation include gastroesophageal reflux disease (GERD), oral infections, sinusitis, pregnancy, and neurological disorders like cerebral palsy or ALS.
Some key factors that contribute to hypersalivation in Parkinson's disease include:
- Saliva hypersecretion
- Inability of saliva retention in the oral cavity (hypomimia, involuntary mouth opening, declining posture or drooping head)
- Salivary clearance deterioration (lingual bradykinesia, oropharyngeal dysphagia, upper esophageal sphincter dysfunction) 2 Medications that can trigger hypersalivation include clozapine, pilocarpine, and cholinergic drugs that stimulate saliva production. Physiological causes of hypersalivation include the early stages of pregnancy, teething in infants, and anticipation of food (particularly sour or spicy items).
Treatment of hypersalivation depends on identifying and addressing the underlying cause, which might involve medication adjustments, treating infections, or managing neurological conditions. For symptomatic relief, botulinum toxin therapies are considered the most effective method for treating hypersalivation in patients with Parkinson's disease 2, 1. Anticholinergic medications like glycopyrrolate or scopolamine may also be prescribed, though these can cause side effects like dry mouth, blurred vision, and constipation. A multidisciplinary approach is necessary to manage hypersalivation in patients with Parkinson's disease, taking into account the complexity of salivary problems and the need to avoid mutually counteracting treatments from different healthcare professionals 3.