PSP Association

Glycopyrrolate or Atropine?

I found this article because I noticed my husbands salivary secretions are still quite heavy using the newly prescribed drug, Atropine .... I discovered Glycopyrrolate's efficacy as compared to Atropine and will go back to the original prescription in 4 hours (though Atropine has a half life of 2 hours)

Another article noted that half of the Atropine taken is "lost " in the urine.....and as noted only has a half life of 2 hours.....My husband probably slobbered a 1/2 liter worth yesterday!

Praise the Lord he's sloberin' at all


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J R Soc Med. 1980 Oct; 73(10): 727–730.

PMCID: PMC1438092

Comparison of the effects of atropine and glycopyrrolate on various end-organs1

R K Mirakhur and J W Dundee

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This article has been cited by other articles in PMC.


Atropine and glycopyrrolate (glycopyrronium bromide), a quaternary ammonium drug, were evaluated in volunteers following intramuscular administration with respect to effects on various end-organs with cholinergic innervation. Glycopyrrolate appears to be five to six times more potent than atropine in its antisialogogue effect and also exhibits a selective, though prolonged, effect on salivary secretion and sweat gland activity. It has minimal cardiovascular, ocular and central nervous system effects.

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Thanks for this, definitely interesting. Atropine is working at the moment for my mum, but there is still some thick phelm like salvia.

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Thanks AVB, I'll note this down for future reference.


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M's experience with Glycopyrronium was that it was very effective at first. The original low dose (1tab a day) was like magic normalised saliva immediately and lasted about 2 months then effect wore off and saliva control re-established by doubling the dose (2tabs a day) then about every 4 weeks an extra tab until we reached max dose 8 at about a year. So from our experience (M and I) Glycopyrronium is great at giving a year's respite but is not long term.

We found atropine worked if we could get it on to M's tongue but as M would not open her mouth rarely done so put towards back of lower gums eased the flow but only short term. But was used for longer without loss of effectiveness.

Only other control was hyocene the patches were a solution but major side effects, so no use for M. The use of liquid hyocene (sorry cannot remember med) to counter stomach reflux (side effect of long term PEG) had a side effect of reducing saliva.

Hope my experience of use.



Did dr's consider a combination of Atropine and glyco...? The Atropine has a major half life that seems to really increase the saliva....It's like it was just held in storage til atropine wore off then flood gates opened.... Glyco is 2mg a day with less drainage though like you said the effectiveness has worn off...We have yet to try the patch though B probably would not go for it....

How you doin?




Sorry AVB our Dr did not try combination as they were trying to extend period of saliva control by using one at time.

Glad B at home and cross fingers he is stabilising, no more pneumonia.

Getting on with life but massive hole that doesn't want to fill, well not yet. Have to start clearing M's wardrobe and nick knacks but can't get started.

Hope you are getting some sleep and help. Best wishes Tim

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I hear ya....I have started the cleaning out months ago. I want to be sort of done with it all before it's all done....B no longer wears any of his clothes but t-shirts and elastic waist pants and a hoody....for church he wears levis that fit him 10kg ago and a one or two specific button downs.....even those started becoming unliked....unfortunatly my sons don't wear same size as dad matter, just go straight to the Salvation Army...

Spring is coming along and maybe in a couple a months you can take a vacation that is not too remeniscent to depression but a place you'd like to hang out for awhile...or get kids and go ...

I hope that the hole in your life is happily soon filled.



Thank you AVB

Like minds, I use The Salvation Army as well they not only give to locals but also check out what I give and do not just rag (though most of what was mine is only rags) unlike the other local charities. Hope B continues to fight the PSP and you are looking after yourself. Best wishes Tim

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SA is the only charity that uses 40-60% of their donation straight to charitable efforts......We have an SA housing facility in town ...they have to be out by 7 am and only in by 4, except on cold days....It's filled nightly so you know SAs work goes to use daily!

However I do see 4000kg dumpsters filled to the brink...people dumping off broken furniture as easy access to getting rid of junk! I tell you I have some broken furniture in my garage cuz I don't have a way to get it to the dump! Ugh a whole nother issue...



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