A review of options for treating sialorrhea in amyotrophic lateral sclerosis

Paolo Banfi, Nicola Ticozzi, Agata Lax, Giulia Andrea Guidugli, Antonello Nicolini, Vincenzo Silani

Research output: Contribution to journalArticlepeer-review


Sialorrhea or drooling represents quite a common problem in patients with amyotrophic lateral sclerosis (ALS). In this review, we describe the possible treatments for this issue. Current medical management is not always effective: anticholinergic drugs (atropine, glycopyrrolate, amitriptyline, hyoscyamine, and transdermal scopolamine) are often used, but there is very little evidence of their effectiveness in patients with ALS. More invasive treatments, such as botulinum toxin injections and/or radiation therapy in the salivary glands, can be considered when anticholinergic drugs are not effective. In this review, we also explore the possible surgical options for treatment of sialorrhea. Although no specific studies have been conducted on patients with ALS, surgical therapies might represent a valid option for treatment of sialorrhea since there is no tachyphylaxis or need for repeated therapeutic sessions.

Original languageEnglish
Pages (from-to)446-454
Number of pages9
JournalRespiratory Care
Issue number3
Publication statusPublished - Mar 1 2015


  • Amyotrophic lateral sclerosis
  • Aspiration pneumonia
  • Botulinum toxin
  • Drooling
  • Quality of life
  • Radiotherapy
  • Salivary glands
  • Sialorrhea
  • Surgical intervention

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine


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