Clinical Autonomic Research

, Volume 21, Issue 6, pp 389–393 | Cite as

An alternative to treat palmar hyperhidrosis: use of oxybutynin

  • Nelson Wolosker
  • Jose R. de Campos
  • Paulo Kauffman
  • Samantha Neves
  • Guilherme Yazbek
  • Fabio B. Jatene
  • Pedro Puech-Leão
Research Article

Abstract

Purpose

To evaluate the effectiveness and patient satisfaction with the use of oxybutynin at low doses for treating palmar hyperhidrosis in a large series of patients.

Methods

From January 2007 to June 2009, 180 consecutive patients with palmar hyperhidrosis were treated with oxybutynin. Data were collected from 139 patients (41 patients were lost to follow-up). During the first week, patients received 2.5 mg of oxybutynin once per day; from the 8th to the 42nd day, 2.5 mg twice per day; and from the 43rd day to the end of the 12th week, 5 mg, twice per day. All of the patients underwent three evaluations before and after the oxybutynin treatment (at 6 and 12 weeks), using a clinical questionnaire and a clinical protocol for quality of life (QOL).

Results

More than 80% of the patients experienced an improvement in palmar hyperhidrosis. Most of the patients showed improvements in their QOL (74.6%). The side effects were minor, with dry mouth being the most frequent (70.5%).

Conclusion

The use of oxybutynin is an alternative as the first step in the treatment of palmar hyperhidrosis, given that it presents good results and improves QOL.

Keywords

Hyperhidrosis Quality of life Clinical treatment (oxybutynin) 

References

  1. 1.
    Weber A, Heger S, Sinkgraven R, Heckmann M, Elsner P, Rzany B (2005) Psychosocial aspects of patients with focal hyperhidrosis. Marked reduction of social phobia, anxiety and depression and increased quality of life after treatment with botulinum toxin A. Br J Dermatol 152(2):342–345Google Scholar
  2. 2.
    Stolman LP (2003) Treatment of hyperhidrosis. J Drugs Dermatol 2(5):521–527PubMedGoogle Scholar
  3. 3.
    Yazbek G, Wolosker N, de Campos JR, Kauffman P, Ishy A, Puech-Leão P (2005) Palmar hyperhidrosis—which is the best level of denervation using video-assisted thoracoscopic sympathectomy: T2 or T3 ganglion? J Vasc Surg 42(2):281–285PubMedCrossRefGoogle Scholar
  4. 4.
    Wolosker N, Yazbek G, Ishy A, de Campos JR, Kauffman P, Puech-Leão P (2008) Is sympathectomy at T4 level better than at T3 level for treating palmar hyperhidrosis? J Laparoendosc Adv Surg Tech A 18(1):102–106PubMedCrossRefGoogle Scholar
  5. 5.
    Yazbek G, Wolosker N, Kauffman P, de Campos JR, Puech-Leão P, Jatene FB (2009) Twenty months of evolution following sympathectomy on patients with palmar hyperhidrosis: sympathectomy at the T3 level is better than at the T2 level. Clinics 64(8):743–749PubMedCrossRefGoogle Scholar
  6. 6.
    de Campos JR, Wolosker N, Takeda FR, Kauffman P, Kuzniec S, Jatene FB, de Oliveira SA (2005) The body mass index and level of resection: predictive factors for compensatory sweating after sympathectomy. Clin Auton Res 15(2):116–120PubMedCrossRefGoogle Scholar
  7. 7.
    Gossot D, Kabiri H, Caliandro R, Debrosse D, Girard P, Grunenwald D (2001) Early complications of thoracic endoscopic sympathectomy: a prospective study of 940 procedures. Ann Thorac Surg 71(4):1116–1119PubMedCrossRefGoogle Scholar
  8. 8.
    Baumgartner FJ, Bertin S, Konecny J (2009) Superiority of thoracoscopic sympathectomy over medical management for the palmoplantar subset of severe hyperhidrosis. Ann Vasc Surg 23(1):1–7PubMedCrossRefGoogle Scholar
  9. 9.
    Arisco A, Brantly E, Kraus S (2009) Oxybutynin extended release for the management of overactive bladder: a clinical review. Drug Des Devel Ther 21(3):151–161Google Scholar
  10. 10.
    Lefrandt JD, Maurer JM (2007) Oxybutynin for hyperhidrosis. Neth J Med 65(9):356PubMedGoogle Scholar
  11. 11.
    Mijnhout GS, Kloosterman H, Simsek S, Strack van Schijndel RJ, Netelenbos JC (2006) Oxybutynin: dry days for patients with hyperhidrosis. Neth J Med 64:326–328PubMedGoogle Scholar
  12. 12.
    Schollhammer M, Misery L (2007) Treatment of hyperhidrosis with oxybutynin. Arch Dermatol 143(4):544–545PubMedCrossRefGoogle Scholar
  13. 13.
    Tupker RA, Harmsze AM, Deneer VH (2006) Oxybutynin therapy for generalized hyperhidrosis. Arch Dermatol 142(8):1065–1066PubMedCrossRefGoogle Scholar
  14. 14.
    Kim WO, Kil HK, Yoon KB, Yoo JH (2010) Treatment of generalized hyperhidrosis with oxybutynin in post-menopausal patients. Acta Derm Venereol 90(3):291–293PubMedGoogle Scholar
  15. 15.
    Amir M, Arish A, Weinstein Y, Pfeffer M, Levy Y (2000) Impairment in quality of life among patients seeking surgery for hyperhidrosis (excessive sweating): preliminary results. Isr J Psychiatry Relat Sci 37(1):25–31PubMedGoogle Scholar
  16. 16.
    de Campos JR, Kauffman P, Werebe E de C, Andrade Filho LO, Kusniek S, Wolosker N, Jatene FB (2003) Quality of life, before and after thoracic sympathectomy: report on 378 operated patients. Ann Thorac Surg 76(3):886–891Google Scholar
  17. 17.
    Lin TS, Fang HY (1999) Transthoracic endoscopic sympathectomy in the treatment of palmar hyperhidrosis—with emphasis on perioperative management (1,360 case analyses). Surg Neurol 52(5):453–457PubMedCrossRefGoogle Scholar
  18. 18.
    Gelbard CM, Epstein H, Hebert A (2008) Primary pediatric hyperhidrosis: a review of current treatment options. Pediatr Dermatol 25(6):591–598PubMedCrossRefGoogle Scholar
  19. 19.
    Araújo CA, Azevedo IM, Ferreira MA, Ferreira HP, Dantas JL, Medeiros AC (2009) Compensatory sweating after thoracoscopic sympathectomy: characteristics, prevalence and influence on patient satisfaction. J Bras Pneumol 35(3):213–220PubMedCrossRefGoogle Scholar
  20. 20.
    Nabi G, Cody JD, Ellis G, Herbison P, Hay-Smith J (2006) Anticholinergic drugs versus placebo for overactive bladder syndrome in adults. Cochrane Database Syst Rev 18(4):CD003781Google Scholar
  21. 21.
    Sayeed RA, Nyamekye I, Ghauri AS, Poskitt KR (1998) Quality of life after transthoracic endoscopic sympathectomy for upper limb hyperhidrosis. Eur J Surg Suppl 580:39–42PubMedGoogle Scholar
  22. 22.
    Lau WT, Lee JD, Dang CR, Lee L (2001) Improvement in quality of life after bilateral transthoracic endoscopic sympathectomy for palmar hyperhidrosis. Hawaii Med J 60(5):126, 137Google Scholar
  23. 23.
    Schmidt J, Bechara FG, Altmeyer P, Zirngibl H (2006) Endoscopic thoracic sympathectomy for severe hyperhidrosis: impact of restrictive denervation on compensatory sweating. Ann Thorac Surg 81(3):1048–1055PubMedCrossRefGoogle Scholar
  24. 24.
    Bachmann K, Standl N, Kaifi J, Busch P, Winkler E, Mann O, Izbicki JR, Strate T (2009) Thoracoscopic sympathectomy for palmar and axillary hyperhidrosis: four-year outcome and quality of life after bilateral 5-mm dual port approach. Surg Endosc 23(7):1587–1593PubMedCrossRefGoogle Scholar
  25. 25.
    Akl EA, Briel M, You JJ, Lamontagne F, Gangji A, Cukierman-Yaffe T et al (2009) LOST to follow-up information in trials (LOST-IT): a protocol on the potential impact. Trials 10:40Google Scholar

Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Nelson Wolosker
    • 1
  • Jose R. de Campos
    • 2
  • Paulo Kauffman
    • 1
  • Samantha Neves
    • 1
  • Guilherme Yazbek
    • 1
  • Fabio B. Jatene
    • 2
  • Pedro Puech-Leão
    • 1
  1. 1.Department of Vascular Surgery, Hospital das Clínicas, School of MedicineUniversity of São PauloSão PauloBrazil
  2. 2.Department of Thoracic Surgery, Hospital das Clínicas, School of MedicineUniversity of São PauloSão PauloBrazil

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