Table 1

Summary of treatment options

Type of therapyBenefits of this approachSide effectsAdditional information
Conservative measuresLargely cheap
  Simple
  Minimal side effects
FewConsider these in all patients
AnticholinergicsEasy to prescribe
  Cheap
Urinary retention, blurred vision, confusionCaution in myasthenia gravis-related drooling
Botulinum toxinTargeted therapyExcessively dry mouthConcerns over effects on bulbar function
RadiotherapyTargeted therapyExcessively dry mouth
  Risk of malignancy
Effects (including adverse effects) last from months to years
SurgeryLong-term symptom relief if effectiveGeneric surgical and anaesthetic risks
  Retention cysts
Irreversible
  Patients may be too frail to tolerate