Title : Low dose of oxybutynin in primary hyperhydrosis: A prospective study from a tertiary care center in Nepal
Abstract:
Introduction: Hyperhidrosis is a clinical condition where there is excessive sweating beyond the physiological need of the patient's body. This can directly or indirectly affect the quality of a patient's life. Oxybutynin is widely used in urology as an anticholinergic medication for bladder urge incontinence. It can be used safely at a high dose (over 15 mg/day) to treat the urological disorder. It also acts against excessive sweating and can be used in cases of hyperhidrosis.
Objective: To evaluate effectiveness of oxybutin at low dose and to assess the Hyperhidrosis Disease Severity Scale (HDSS) .
Materials and Methods: This is a hospital-based cross-sectional study in primary Hyperhidrosis. Oxybutynin was prescribed to all patients of primary hyperhidrosis with a gradual increment of dosage of 2.5 mg orally once a day to 5 mg twice a day. Patients were evaluated at zero wk ( baseline), 4wk, 8 wk, 12 wk and follow up in 16 wks with Hyperhidrosis Disease Severity Scale (HDSS) along with adverse effects were noted.
Result: There is a significant difference in HDSS at zero wk( baseline) and 4th wk(p=0.001) at a dose of 2.5 mg once a day of oxybutynin. Also, a significant difference was noted (p=0.022) in HDSS between zero wk (baseline and 12 wk. Similarly, a significant difference between HDSS at zero wk( baseline) versus the 16th wk was also noted.
Conclusion: Oxybutynin is an anticholinergic drug with an emerging role in hyperhidrosis. Low doses have shown good results with minimal side effects. The dose requirement varies among authors. Studies with long-term follow-ups with ideal protocols need to be established in the future.
Keywords: Anti-cholinergic, Hyperhidrosis, Scoring system, Oxybutynin.
