Hypersalivation
Hypersalivation or hypersialosis is the excessive production of saliva. It has also been defined as increased amount of saliva in the mouth, which may also be caused by decreased clearance of saliva.
Hypersalivation can contribute to drooling if there is an inability to keep the mouth closed or difficulty in swallowing the excess saliva, which can lead to excessive spitting.
Hypersalivation also often precedes emesis, where it accompanies nausea.
Causes
Excessive production
Conditions that can cause saliva overproduction include:- Rabies
- Pellagra
- Gastroesophageal reflux disease, in such cases specifically called a water brash, and is characterized by a sour fluid or almost tasteless saliva in the mouth
- Gastroparesis
- Pregnancy
- Fluoride therapy
- Excessive starch intake
- Anxiety
- Pancreatitis
- Liver disease
- Serotonin syndrome
- Mouth ulcers
- Oral infections
- Sjögren syndrome
- aripiprazole
- clozapine
- pilocarpine
- ketamine
- potassium chlorate
- risperidone
- pyridostigmine
- mercury
- copper
- organophosphates
- arsenic
- nicotine
- thallium
Decreased clearance
- Infections such as tonsillitis, retropharyngeal and peritonsillar abscesses, epiglottitis and mumps.
- Problems with the jaw, e.g., fracture or dislocation
- Radiation therapy
- Neurologic disorders such as Amyotrophic lateral sclerosis, myasthenia gravis, Parkinson's disease, multiple system atrophy, rabies, bulbar paralysis, bilateral facial nerve palsy, frontotemporal dementia, and hypoglossal nerve palsy
Treatment
In the palliative care setting, anticholinergics and similar drugs that would normally reduce the production of saliva causing a dry mouth could be considered for symptom management: scopolamine, atropine, propantheline, hyoscine, amitriptyline, glycopyrrolate.
As of 2008, it is unclear if medication for people who have too much saliva due to clozapine treatment is useful.