Parasympathomimetic drugs for the treatment of salivary gland dysfunction due to radiotherapy

Abstract

There is limited evidence to support the use of pilocarpine hydrochloride in the treatment of radiation-induced salivary gland dysfunction. Currently, there is little evidence to support the use of other parasympathomimetic drugs in the treatment of this condition. Available studies suggest approximately half of patients will respond, but side effects to responders can be problematic. Adverse effects are dose dependent therefore it is important to keep dose to 5 mg tds.

The effects of antidepressants and pilocarpine on rat parotid glands: an immunohistochemical study

“…In the present study, pilocarpine exerted a significant secretagogue effect, which showed its cholinergic agonist capacity and corroborated the findings of Davies and Shorthose 29. Pilocarpine was associated with an increase in SSFR and efficiently treated the hyposalivation caused by venlafaxine (groups VS60 and VP60).…”

“…In the present study, pilocarpine exerted a significant secretagogue effect, which showed its cholinergic agonist capacity and corroborated the findings of Davies and Shorthose. 29 Pilocarpine was associated with an increase in SSFR and efficiently treated the hyposalivation caused by venlafaxine (groups VS60 and VP60). Conversely, when pilocarpine was used in association with fluoxetine (group FP60), there was no SSFR increase compared with the group that did not receive pilocarpine (group FS60 – Table 3 ).…”

The effects of antidepressants and pilocarpine on rat parotid glands: an immunohistochemical study

“…In the present study, pilocarpine exerted a significant secretagogue effect, which showed its cholinergic agonist capacity and corroborated the findings of Davies and Shorthose 29. Pilocarpine was associated with an increase in SSFR and efficiently treated the hyposalivation caused by venlafaxine (groups VS60 and VP60).…”

“…In the present study, pilocarpine exerted a significant secretagogue effect, which showed its cholinergic agonist capacity and corroborated the findings of Davies and Shorthose. 29 Pilocarpine was associated with an increase in SSFR and efficiently treated the hyposalivation caused by venlafaxine (groups VS60 and VP60). Conversely, when pilocarpine was used in association with fluoxetine (group FP60), there was no SSFR increase compared with the group that did not receive pilocarpine (group FS60 – Table 3 ).…”

Testing pilocarpine drops for dry mouth in advanced cancer using n-of-1 trials: A feasibility study

“…A systematic review of pilocarpine in radiation-induced xerostomia, which included the afore-mentioned study of pilocarpine tablets 5 mg tds, 28 found the response rate was 42%–51%, which is similar to ours (two of the four patients completing our study responded). The side effect rate was high, and side effects (e.g.…”

The Method Quality of Cross-Over Studies Involved in Cochrane Systematic Reviews

“…In addition, 2 CSRs applied both the Cochrane handbook standard and the Jadad Scale [ 11 , 12 ]. Though several CSRs [ 13 – 15 ] considered “wash out” or “carry-over effect” in cross-over studies, none of the sampled CSRs comprehensively followed the suggestions from Cochrane handbook to formally assess the potential risk of bias.…”

The effects of antidepressants and pilocarpine on rat parotid glands: an immunohistochemical study

“…In the present study, pilocarpine exerted a significant secretagogue effect, which showed its cholinergic agonist capacity and corroborated the findings of Davies and Shorthose 29. Pilocarpine was associated with an increase in SSFR and efficiently treated the hyposalivation caused by venlafaxine (groups VS60 and VP60).…”

“…In the present study, pilocarpine exerted a significant secretagogue effect, which showed its cholinergic agonist capacity and corroborated the findings of Davies and Shorthose. 29 Pilocarpine was associated with an increase in SSFR and efficiently treated the hyposalivation caused by venlafaxine (groups VS60 and VP60). Conversely, when pilocarpine was used in association with fluoxetine (group FP60), there was no SSFR increase compared with the group that did not receive pilocarpine (group FS60 – Table 3 ).…”

Testing pilocarpine drops for dry mouth in advanced cancer using n-of-1 trials: A feasibility study

“…A systematic review of pilocarpine in radiation-induced xerostomia, which included the afore-mentioned study of pilocarpine tablets 5 mg tds, 28 found the response rate was 42%–51%, which is similar to ours (two of the four patients completing our study responded). The side effect rate was high, and side effects (e.g.…”

The Method Quality of Cross-Over Studies Involved in Cochrane Systematic Reviews

“…In addition, 2 CSRs applied both the Cochrane handbook standard and the Jadad Scale [ 11 , 12 ]. Though several CSRs [ 13 – 15 ] considered “wash out” or “carry-over effect” in cross-over studies, none of the sampled CSRs comprehensively followed the suggestions from Cochrane handbook to formally assess the potential risk of bias.…”

The effects of antidepressants and pilocarpine on rat parotid glands: an immunohistochemical study

“…In the present study, pilocarpine exerted a significant secretagogue effect, which showed its cholinergic agonist capacity and corroborated the findings of Davies and Shorthose 29. Pilocarpine was associated with an increase in SSFR and efficiently treated the hyposalivation caused by venlafaxine (groups VS60 and VP60).…”

“…In the present study, pilocarpine exerted a significant secretagogue effect, which showed its cholinergic agonist capacity and corroborated the findings of Davies and Shorthose. 29 Pilocarpine was associated with an increase in SSFR and efficiently treated the hyposalivation caused by venlafaxine (groups VS60 and VP60). Conversely, when pilocarpine was used in association with fluoxetine (group FP60), there was no SSFR increase compared with the group that did not receive pilocarpine (group FS60 – Table 3 ).…”

Testing pilocarpine drops for dry mouth in advanced cancer using n-of-1 trials: A feasibility study

“…A systematic review of pilocarpine in radiation-induced xerostomia, which included the afore-mentioned study of pilocarpine tablets 5 mg tds, 28 found the response rate was 42%–51%, which is similar to ours (two of the four patients completing our study responded). The side effect rate was high, and side effects (e.g.…”

The Method Quality of Cross-Over Studies Involved in Cochrane Systematic Reviews

“…In addition, 2 CSRs applied both the Cochrane handbook standard and the Jadad Scale [ 11 , 12 ]. Though several CSRs [ 13 – 15 ] considered “wash out” or “carry-over effect” in cross-over studies, none of the sampled CSRs comprehensively followed the suggestions from Cochrane handbook to formally assess the potential risk of bias.…”