Effectiveness of Oral Glycopyrrolate Use in Compensatory Hyperhidrosis Patients

Abstract

Compensatory hyperhidrosis or reflex hyperhidrosis is the increase in sweating in the postoperative stage of thoracic sympathectomy or lumbar sympathectomy. It shares several features with anxiety disorders and has a negative impact on a patient's quality of life. Oralglycopyrrolate is one of the treatment options available. This study reviewed case notes in a series of 19 patients with compensatory hyperhidrosis. We made a comparison between the Milanez de Campos score of a pre-glycopyrrolate medication group and the Milanez de Campos score of a post-glycopyrrolate medication group. The Beck Depression Inventory (BDI) score, Beck Anxiety Inventory (BAI) score, and autonomic nervous system (ANS) scale score were also compared between the pre-medication and post-medication groups. In the post-glycopyrrolate medication group, there was decrease in the Milanez de Campos score, BAI score, and BDI score (P < 0.05). But no meaningful change was seen in the ANS score in the post-glycopyrrolate medication group (P > 0.05). Glycopyrrolate is an effective medication in the treatment of compensatory hyperhidrosis that, can alleviate anxiety and improve patients' quality of life.

Compensatory Hyperhidrosis: Results of Pharmacologic Treatment With Oxybutynin

“…Regarding the QOL assessment, there was a statistically significant improvement in our series of patients (pretreatment ¼ 75.24 versus posttreatment ¼ 43.48; p ¼ < 0.001), which is similar to the outcome of the study by Gong and colleagues [19]. Because of the retrospective nature of our study, we were unfortunately only able to assess QOL after 6 weeks of treatment and not at the last consult.…”

“…Patients assessed the following: (1) impression of amelioration at the site of hyperhidrosis that necessitated operation, (2) QOL using a valid questionnaire for hyperhidrosis [3] that was used by different authors in this field [18,19] before beginning pharmacologic treatment, (3) clinical improvement in CH after 6 weeks of therapy, (4) QOL after 6 weeks of CH treatment, (5) clinical improvement in CH at the final visit (the final consultation occurring at least 6 months after the beginning of treatment), (6) complaints of pharmacologic side effects both after 6 weeks and at the last visit, and (7) impression of ameliorated CH symptoms present at other sites at the last visit.…”

“…Glycopyrrolate (an anticholinergic agent somewhat similar to oxybutynin) has been studied for the treatment of CH [19]: 19 patients were evaluated, and short-term results (1 month) demonstrated a significant improvement in QOL after the use of this anticholinergic drug. During follow-up, none of the patients stopped taking the medication, and its main side effect was dry mouth.…”

Systemic Treatment of Hyperhidrosis

“…A Korean group recently described its experience with glycopyrrolate administered at incremental doses with an initial dose of 2 mg/d and a maximum dose of 8 mg/d. 26,27 In the first study, which involved 36 patients with primary hyperhidrosis, a significant improvement was observed in 75% of the patients, and adverse effects were reported in 36%. 26 In the second study, which investigated the use of glycopyrrolate in 19 patients with compensatory hyperhidrosis following sympathectomy, 79% of patients responded well and 42% experienced adverse effects.…”

“…26 In the second study, which investigated the use of glycopyrrolate in 19 patients with compensatory hyperhidrosis following sympathectomy, 79% of patients responded well and 42% experienced adverse effects. 27 None of the patients in either study stopped treatment because of adverse effects (mainly dry mouth). There has also been an isolated report of the successful use of glycopyrrolate in antidepressant-associated hyperhidrosis.…”