DROOLING (OR SIALORRHEA)
AS AN "ISOLATED" SYMPTOM IN TWO PERSONS, AND ITS TREATMENT WITH
PRIMARILY ANTISTRESS DRUG THERAPY. (Updated)
Renato COCCHI, a neurologist and a medical
psychologist.
(Other two texts on this topic)
Summary.
This report concerns a first history on
short-term results, of an antistress drug therapy in two men, one of 37 and the
other of 28 years, where the drooling appeared as serious isolate trouble. This
symptom was not secondary (or better: tertiary?) to other known illnesses that
have it as a collateral phenomenon.
As an aspecific stress response, the
sialorrhea occurs in many illnesses, which entirely diverge. It may reduce
following antistress drug therapy, as observed in Down persons (Cocchi, 2004b)
and as we are seeing in these two cases, which are near surely the first ones
so treated.
We suggested that the sialorrhea is
creditable to the fact that the stress is able determine a
GABAergic-glutamergic hypothalamic unbalance, with overfunction of the
hypothalamic pathways which control the vagal nuclei, mainly the nucleus
ambiguous, ( It gives origin even to the glossopharyngeal nerve), which became
so overstimulated.
Keywords: Sialorrhea, drooling, stress,
symptom, isolate, adult, males, two, drug therapy, antistress, results,
positive, report, first.
Drug modulation of stress reactions
Home Page / / / Pagina iniziale
After I reported on the sialorrhea in Downs,
either for epidemiology and the long term results of an antistress drug
therapy, although not planned for treating this symptom (Cocchi, 2004a; Cocchi,
2004b), two men came to my observation, suffering from this pathology, as
prevailing symptom, if not exclusive. Drooling much disturbed both them (see,
later on, emails sent to contact me).
I did not give them any certainty, because I
never faced specifically this problem. The positive results, in Downs, were
something of more, after several months of an antistress individualized drug
therapy, which produced such favourable results. About both these cases, I
wanted to report on this article.
Short summary the actual
and personal knowledges on the sialorrhea.
I quote back here, what I wrote previously
as an introduction to my first investigation.
"Sialorrhea, or excess of drooling, is
a symptom in many persons with many different illnesses such as: Cerebral
palsy; Palsies of the cranial nerves VII, IX, and XII; Autism and PDD; Mental
retardation; Stroke; Amyotrophic lateral sclerosis; Down syndrome; Motor neuron
disease;Parkinsonism; Congenital suprabulbar palsy; Head trauma; Encephalitis;
Heavy metal intoxication; Graves' disease (a hypertiroidism); Rabies; Extra-esophageal
reflux disease; Nasal and/or pharyngeal obstruction; Major surgical resection
of structures in the oral cavity/pharynx/hypopharynx.
It is a symptom thant can also be induced by
drugs, during antipsychotic therapies.
Drooling also impairs socially the sufferers
from it and isolation is unfortunately frequent because saliva soils furniture,
carpets, toys, and the clothing of peers, siblings, parents, relatives and
caregivers.
The saliva production comes out from both
the major and minor salivary glands, the secretory action of which is mainly
under the control of the parasympathetic nervous system. Excessive drooling is
a condition that can induce heavy hygienic and psychosocial
problems"(Cocchi, 2004a).
Although the problem of excess salivation
with drooling in Down syndrome persons, was a well-known datum, there was not,
as for me (I searched on Google, and on Medline since 1960 with key words:
sialorrhea, oversalivation, drooling, Down syndrome) any epidemiological
investigation on this symptom. Still now, that I did (Cocchi, 2004a) is the
only one on this special population.
The oversalivation with saliva loss is an
aspecific symptom that we can find in subjects with full different illnesses
(Cocchi, 2004a).
Although we can find it in Down children in
about the 20% of them (Cocchi, 2004a), the sialorrhea cannot be then a symptom
that directly depends from the chromosomal anomaly 21, otherwise all Downs
should have had it.
Furthermore, according to every physicians'
experience, we can observe even in other chromosomal or genetic anomalies (see
later on).
Too inclining to disappear in the Down, with
the age growing, it is of common evidence that some elderly persons start to
lose saliva by day, without having done it never in past.
In preceding research I thought as possible
that the sialorrhea was a symptom of internal metabolic stress, with a district
parasympathetic excess activation coming from the brain (Cocchi, 2004a).
In my second investigation (Cocchi, 2004b) I
confirmed this first idea, even if the link appeared more complex.
The primarily antistress drug therapy I
prescribed, too having significantly driven the disappearance of the symptom in
over than 96% of so treated individuals, did not work in two cases.
This exception remembers, by analogy, what
happens in nighttime enuresis, which in nearly all cases disappears with the
puberty, but such a result is not always so favourable. Being a nighttime
bedwetting person, he had an unfit classification to the military service, in
Italy. So, because otherwise this enuretic young man should have become the
laughingstock of all the fellow soldiers, with many burden
psychological-relational outcomes.
Both the sialorrhea and the daily enuresis
can reappear, or first appear, in elderly persons.
For a drug therapy, other physicians tried
the way of the anticholinergic drugs, owing to the parasympathetic prevalence
of the symptom, having the parasympathetic system, the acetylcholine, as the
main neurotransmitter.
The more studied drugs were the benztropine,
the saltropine, the glycopyrrolate, and the scopolamine. Their effectiveness on
the drooling is much variable and unpredictable, and they not overcome 45% of
the so treated subjects. The anticholinergic drugs act by inhibiting the saliva
secretion through a reversible blockade of the cholinergic receptors which
control it. There are reports of side effects like a dry mouth, dilation of the
pupils, blurred vision, retention of urine, constipation, dizziness and
disorientation, with need of stopping the drug therapy (Ieung and Kao, 1999).
As for I know, no literature on the
relationships between sialorrhea and stress is available, if not for the fact
that sialorrhea elicits a share of secondary stress of psychologicaland social
type. The antistress therapy set up here, was not specifically addressed to the
sialorrhea. It gets its base, as it was for the Downs, on what reported in
Cocchi, 1993, and, generally, on theoretical bases explicated in Cocchi, 2003.
Besides on the sialorrhea in the Down syndrome,
the antistress drug therapy acted favourably on the same disturb in other
illnesses.
It occurred that in cases such as the
Cri-du-chat syndrome (Cocchi, 2001), syndrome of Aicardi-Goutieres (Cocchi,
2002), partial trisomy of the chromosome 22 (Cocchi, 2003 ), GM1 gangliosidosis
(Cocchi, 2003 ), on a mental retardation with microgiry, without any genetic
base found (Cocchi, 2002), and on a typical form of autism (Cocchi, 2005).
The sialorrhea could be creditable to the
fact that the stress can determine gabaergic-glutamergic hypothalamic
unbalance. Sop, it elicits an overfunction of the hypothalamic control pathways
on the vagal nuclei, mainly on the ambiguous nucleus (as a common origin even
of the glossopharyngeal nerve), which becomes overstimulated. An antistress
drug therapy seemed, at least to a large extent, able to bring this mechanism
to a better operation, in Downs ( Cocchi, 2004b.)
Two case histories.
Patient one, by email: "... My name
is...., I read on internet your study about sialorrhea and I am writing you
because I am suffering from acute sialorrhea since about 12 years.
I am 37, a normal person and I have a
normal life. Last year I had the diagnosis of the coeliac disease, and now I am
in a diet for it. Another trouble of mine is the nocturia.
As for the drooling, last years it did
worse so much till it prevents me to speak and then it is conditioning me in
the social relationships.
I searched consultations by all the
possible experts: a neurologist, an otolaryngologist, a gastroenterologist, a
maxillofacial physician and an immunologist.
I acted all the prescribed analyses but
they were all normal.
The neurologist tried to give me some
drugs that would have provoked a dry mouth as a side-effect ( alprazolam, amitriptyline
[The brand names of these two drugs were transcribed by that of their basic
substances. RC], But I did not reach any result.
Since currently this trouble is so
serious that literally prevents me to speak to the people I am looking in their
face, I took the drastic decision to irradiate my salivary glands.
The chief physician of the special
department, the Doctor ...., of the regional hospital of.... (the town where I
live) during the last consultation told me that it can be done. Nevertheless I
need to be aware that this intervention has the risk that in the future I could
develop a cancer in that body district. I am willing equally to do this
treatment.
Here I kindly to ask you, before
undergoing X-ray treatment if she knows an alternative treatment or the
possible causes of this problem.
I thank you infinitely as for the
attention I get from you and for your precious time you will spend to answer
me."
The second ten days of June 2005, the first
consultation. He is man of 37 years, married, who works as a selling agent.
He has continuous drooling, but not during
the night. This trouble appeared 12 years ago, with all the implications and
the consequences described in his email searching for a first contact.
Moreover, because his job needs a continuous
verbal in touch with the single interlocutor. Any of the many consulted experts
found the starting point, and if the sialorrhea were a secondary symptom of a
well-known disease. Equally any could set up some advantageous therapy.
I noticed him that I never treated this
symptom as such, and what I obtained in Downs was a collateral result.
Therefore I know that it is an aspecific symptom and it relates to stress
reaction, but I don't know times of response to a possible antistress therapy.
Stress symptoms: He suffers from heat, has a sweet tooth, mainly for
the sweet things with the milk cream, but had normal liking for the meat broth.
He says is having a coeliac disease [??]. Now, he can stand the light, the
noise and the confusion. Fainting feelings do not occur. His hair is dry. He
has emotional axillary perspiration. Nocturia runs at least twice in every
night.
During the sleep he inclines to have much
movement. In certain days he has dyslalias. He doesn't remember to have yawn
excess. Rarely he suffers from any headache. There is a tendency to dream
disastrous situations, but not always he is waking up.
Possible troubles of half-brain
dominance: He admits possible
intrusive thought. His concentration has now some difficulty. He is not an
undecided person. Perhaps he counts objects without any reason.
Depressive symptoms: To the test "Which is the opposite of the
colour Red? he answered Black, but denies of being depressed. As for his diet,
he does not need tp look for milk or dairy. In the afternoon, he is more
activated. He denies being a wine drinker or of other alcoholic drinks. He
doesn't search an intercourse for falling asleep.
Other: At school, till about his 12 years, he was very hyperactive and even
now he is quite so. In his first year of life hr cried much and slept a few.
Test therapy (daily doses, by the oral via):
Glutamine 125mg; Amantadine 50mg; Pyridoxine 75mg; Nortriptyline 10mg;
Carbamazepine 100mg; Oxazepam 7.5mg.
First 10 days of September 2005, the first
checkup after 84 therapy days. An EEG examination was reported as normal.
He is doing better with less drooling, and
he thinks that when at the beginning his sialorrhea was equal to 100, now he
evaluates it as 70 (He improved of 30%).
The effect of the therapy works till 5-6 PM.
If he is under stress, he restarts drooling in advance. His sleep is not as
first and perhaps he sleeps a little better, and he has no drowsiness in the
morning.
Perhaps there are fewre bad dreams. During
sleep, he is moving as he did previously. His head is not more clear from
intrusive thoughts, perhaps he not has them [A debatable assertion, because the
concentration trouble leads to presume the opposite. R.C.]. The memory
difficulties did not improve. He did not observe any variation on the possible
depressed mood. The intake of sweet things did not change. In the afternoon is
always more active. Axillary oversweating is as first. His work runs as usual.
Now, he uses dressing with more vivacious colours. Dyslalias are not
diminished. Perhaps he has more headaches, of a diffused type.
Therapeutic variation (daily doses, by the
oral via): Carbamazepine 200mg; oxazepam 15mg.
Ten third days of January 2006: The second
checkup after six months of drug therapy. According to him, the excessive
salivation diminished of 30-40%. He doesn't do more soil dreams. In his work is
more uninhibited, but he has always needed to lead one hand before his mouth.
He has still problems of fluctuating intrusive thoughts and of concentration
lacking. Lately his sleep is more troubled, and he has some wake up again, with
two nocturia episodes. The headache unchanged. Still dyslalias occur, as the
preceding checkup. The axillary oversweating did not stop. Hyperactivity is
always the same. The quality of his work improved.
Therapeutic variation (daily doses, by the
oral via) hanging nortriptyline and 100mg carbamazepine. I prescribed
amitriptyline 10mg to and valpromide 300mg.
Patient 2, by email: .... I am writing
him from.... I have 28 years and about since three the quality of my life
generally much reduced or better my life became a disaster. It happened so,
because of this damned sialorrhea, which unintentionally jumps always out of me
in any environment and with all people, except my parents.
I am straight losing my job. ... In a
year I consulted practically all medical experts, as psychiatrists,
psychologists, homeopaths, neurologists and otolaryngologists. I have spent a
lot of money, and since about one month I am assuming benzodiazepines and
anticholinergic drugs, but this problem reappears regularly in the evening. I
feel notable uneasiness and indescribable difficulty in the interpersonal
relationships. ...
Third ten days of June 2005, the first
consultation. A man, of 28 years, single. He is working in a shoe's factory and
weighs 80kg, in spite of an active sporting life.
Since three years he has sialorrhea, not
controllable. It appears as an evident issue of saliva dripping directed towards
the persons who are near him. This symptom does not occur in presence of his
parents or of close relatives, while this happens with extraneous or unknown
persons, or even friends. The excess saliva production doesn't own different
intensity between morning and afternoon. He doesn't lose saliva when sleeping,
and he thinks that this disturbs has an emotional base.
Stress symptoms: He suffers from heat. There is not an increased food
intake of sweet things, meat broth, milk and dairy. Currently he doesn't sleep
well and he wake once in every night. Some time he spoke during the sleep,
while he never had nighttime muscular cramps.
He doesn't know if he has nighttime bruxism,
but he realized his dental shut during the day. No intolerance to the light, to
the noise, or to the confusion occur. At the morning, he uses the alarm clock
to wake up, and often he feels tired, as if he has never had forces. He is
hungry at once, and inclines to eat much.
When he becomes anger, usually doesn't
manifest it, but there are moments where he needs say blasphemy, or swearwords,
apparently for no reason. His hair is fat. He suffers from emotional hands'
oversweating, has frequent colic and diarrheas. The redness of the eyes is rare
for no reason. Mediastinal oppression does not happen, but in past he had the
lump in the throat. Moreover, he is hungry of air, has disbandment and fainting
feelings.
Problems of half-brain dominance: To the test "Which the opposite of the colour
Red," he answers "Green": He was a Contrary Mary. He did not end
the studies of the high school, because he had concentration failures. In past,
he had intrusive thinking, but now it is less frequent. Suddenly he has bad
thoughts against persons otherwise beloved. Usually he does bad dreams, and he has
also a negative vision of the world.
Depressive elements: In his father's family, there was a predisposition
to depression. As a young boy he was a jolly fellow. Any headache doesn't
occur, but his head is sometime dull. Often tachycardia appears, and some panic
attack too. Suicide ideas came out. Now he is taking a drug therapy with
perphenazine, orphenadrine and paroxetine, which give him problems of
precocious ejaculation, and even erection troubles. The excess of saliva
induced him secondary psychological troubles (see email of first contact).
Other: In past he did irregular use of cannabis indica and of
3,4-metilen-dioxi-metamphetamine (MDMA), a derivative from the methamphetamine
with the popular name of Extasy. He played European foot-ball, with good
technique.
Risk factors in his mother's pregnancy
and during delivery and their exits: Not abortion threats were reported. He
is a person born to term, with prolonged, delivery with birthweight of 3250
grams. He had not had cyanosis, neither pathological jaundice, nor respiratory
distress, but 24 hours of coma in the first week of life. In the same year he
had a new coma of six months. Gastroenterites occurred to the first year life,
because he doesn't bear his mother's milk. He was not a hyperkinetic child.
Test therapy (daily doses, by the oral via):
125mg glutamine; pyridoxine 75mg; carbamazepine 100mg; diazepam 2mg; paroxetine
10mg.
First 10 days of August 2005, the first
checkup after 35 days of drug therapy.
As for the excess of saliva, he thinks that
there is quantitative diminution of the expelled liquid from the mouth.
His general well-being, according to him,
did not change. He sleeps a little better, does not have any more wake ups
during the night, no more bad dreams, but at morning he feels more tired [??].
He does labour to get up. Abdominal tension did not decrease. His head is
dazed, as first. The dental shut diminished. He eats much, as before this
therapy. Less colic and diarrheas and less burning of the eyes occur.
The irritability level, with blasphemy and
swearwords periods, did not get any modification. The disbandment feelings
remained, but he missed those of fainting. Tachycardia is still current, but no
more air hunger. Panic attacks reduced. His hair is fat as first and the hand
oversweating did not diminish. After six days of drug therapy his troubles of
erection and precocious ejaculation stopped.
Therapeutic variation (daily doses, by the
oral via): Hanging the paroxetine. I prescribed amitriptyline + perphenazine
20mg + 4mg; Carbamazepine 200mg; Glutamine 250mg; Diazepam 4mg.
First 10 days of August 2005, the first
checkup after 35 days of drug therapy.
As for the excess of saliva, he thinks that
there is quantitative diminution of the expelled liquid from the mouth.
His general well-being, according to him,
did not change. Hu sleeps a little better, do not have more wake ups during the
night, no more bad dreams, but at morning he feels more tired [??]. He does
labours to get up. Abdominal tension did not decreased. His head is dazed, as
first. The dental shut diminished. He eats much, as before this therapy. Less
colic and diarrheas and less burning of the eyes occur.
The irritability level, with swearword and
swearwords periods, did not modify. The disbandment feelings remained, but he
missed those of fainting. Tachycardia is still current, but no more air hunger.
Panic attacks reduced. Hus hair is fat as first, the hand oversweating did not
diminished. After 6 days of drug therapy his troubles of erection and
precocious ejaculation stopped.
Therapeutic variation (daily doses, by the
oral via): Hanging the paroxetine. I prescribed amitriptyline + perphenazine
20mg + 4mg; Carbamazepine 200mg; Glutamine 250mg; Diazepam 4mg.
Second ten days of October 2005, the second
checkup, after 110 days of drug therapy. He is doing better: The sialorrhea,
judged as 100 at the beginning of the therapy, now has 65 as his evaluation.
There is no difference between morning and afternoon. Being asked about it, he
says that nobody observed this positive result, then he admits that his
girlfriend and some workmates noted it.
The relationship with his job improved,
where he shows more personality and more grit. The intrusive thinking
diminished, and it happened so as for the emergency of bad thoughts against
otherwise beloved persons. The excessive feeding did not reduce. Now he is
88kg, and he is much worried about it.
He says that he gets up as tired as first.
His hairs are falling, for seborrheic dermatitis. There is still the need to
howl and curse. Suicide ideas did not miss. He sleeps well, and has more
dreams, with more vivid dreams. Disbandment feelings still occur, but less
tachycardia. Now he is less depressed, and he attributes this fact to the
reduction of the sialorrhea, and then of the related secondary depression. The
dental shut is returned as first, mainly towards the evening. Not more burning
of the eyes happened. The panic attacks reappeared. Colic and diarrheas
subsequently reduced. Now he does not drink coffee after lunch or dinner,
because it has a laxative effect.
Therapeutic variation (daily doses, by oral
via): Hanging amitriptyline + perphenazine. I prescribed: Glutamine 125mg;
Pyridoxine 150mg; Chlomipramine 10mg; Nortriptyline 10mg; Carbamazepine 300mg.
The second ten days of February 2006, the
third checkup. As for him, he is worse. No more drooling occurs, but neither
less. He says the sialorrhea is now 65% of what rated at the beginning and
affirms that he has more labour when speaking with the others, as if was at the
preceding checkup.
With the chlomipramine he feels more
stimulated, more uninhibited. He feels that, internally, he would react when
someone offends him, but he maintains his control.
With the persons with whom he does not has
drooling, he is more in touch, but not with the persons in presence of them he
loses his saliva.
In his working place, he is going slightly
better, and has lesser drooling. In this time he feels less of the judgment of the
others, or of what he thinks that the others could think about him. He would
like to do better, even with her friends, with whom he has still sialorrhea. He
feels himself not entirely accepted since he started to salivate in excess.
His sexual activity is now normal. He has
loosened 4kg, since the preceding checkup and now he is weighing 84kg. The fall
of his hair reduced, but he has more itch in his head. The capillary sebum
increased. His need to howl or to curse did not change. He sleeps well, dreams
much, but does misfortune dreams. The feelings of disbandment diminished, while
the tachycardia did mot change. He thinks to be depressed as first [In
facts, he smiles much more, a datum confirmed even by his girlfriend who
attended his consultation. RC].
The dental shut increased, while
oversweating of his hands diminished, or nearly missed. Burning of his eyes
lowered. The panic attacks are less intense, but colic and diarrheas were more
frequent. His bowel stimulation that follows the coffee drinking (even
decaffeinated!) after the lunch, decreased.
Therapeutic variation (daily doses, by the
oral via): Carbamazepine 100mg; valpromide 300mg; diazepam 6mg.
Second ten days of May 2006, the fourth
control. He stopped to take the valpromide at the end of April, because, he
thought, it doesn't give any results. He is growing fat still. Now, he says
that the drooling is unchanged. Now he has the habit of scraping off and this
gives him bother to the throat.
In the working place he is doing better [That
means less sialorrhea. RC], while when he meets his friends the drooling is
not reduced. Currently, he feels more the problem of his difficulty to talk,
than that of the sialorrhea [???].
Therapeutic variation (daily doses, by the
oral via): Hanging the valpromide; I prescribed amantadine 100mg;
S-adenosil-l-methionine 200mg.
Discussion.
The initial histories of both these patients
need, to be understood, some premises. In spite of my experience with antistress
drugs in Down persons, and in other subjects, the positive results on the
sialorrhea were always a side effect of those therapies.
When someone asked me a specific action on
the sialorrhea, which appeared as an isolate symptom and not a secondary one to
other known illnesses, I clarified to both patients that I have never treated
this symptom as such. For which I did not know if it had any link to the
stress, as I thought. In such a case I had an idea about which drugs I could
choose, according to individual responses to stress. Moreover I did not know
which doses I would have to use, and the presumable times of positive
answering. The reference stress symptoms could be detected. For the doses, I
would have held precautionary behaviour, and the answering times were full to
discover.
The situation of both patients heartfelt as
desperate era (and, in one of them, the intention to have his salivary glands
radiated says it enough, about it),
for which both agree to act as guinea-pigs.
How I was expecting, I found stress symptoms
in abundance, even if differently in each patient. In both these cases the
sialorrhea would be as secondary in the stress condition, and what found again
in many different illnesses, therefore it would be as tertiary, according the
sequence: --> illness ---> stress reactions --> sialorrhea. The fact
that every illness elicits even stress symptoms is one assumption of this site
(see the guidelines in <www.stress-cocchi.net/index.htm). The difference of
the stress symptoms, drew to a different choice of the drugs for the test
therapy, set up according to the presence or absence of some of these symptoms.
I first prescribed always modest doses, but in spite of it, some results can
already be observed at the first checkup. Even if the checkups occurred in
different times, by telephone information, in both patients, the times of
improvement were between 35 and about 50 days.
Both patients had some depression, which, in
the second patient, it was not only secondary to the psychological troubles
induced by the sialorrhea.
As for the resolution times of the trouble,
they all are still to discover. Even at the moment of the possible
disappearance of the trouble, we will not know still we acted a substituting
therapy, like that for the essential hypertension, as to understand, or a
curative therapy.
Conclusions.
This is the first report on short-term
results, of an antistress drug therapy in two men, one of 37 and one of 28
years, where the sialorrhea appeared as serious isolate trouble, and not
secondary to other known illnesses where we can find it.
As an aspecific stress response, the
sialorrhea occurs in many illnesses, which entirely diverge. It may reduce
following antistress drug therapy, as observed in Down persons (Cocchi, 2004b)
and as we are seeing in these two cases, which are near surely the first ones
so treated.
We suggested that the sialorrhea be
creditable to the fact that the stress is able determine a
GABAergic-glutamergic hypothalamic unbalance. It leads so to overfunction of
the hypothalamic pathways, which control the vagal nuclei, mainly the nucleus
ambiguous, (it gives origin even to the glossopharyngeal nerve), which became
so overstimulated.
References.
Cocchi R. Drug therapy in Down's syndrome: A
theoretical context . It. J. Intellect. Impair. 1993, 6: 143-154.
Cocchi R. First months of drug therapy
in a Cri-du-chat case November
2001.<www.stress-cocchi.net/genetics3.htm>
Cocchi R. Drug therapy in
Aicardi-Goutieres syndrome: Report of a 51-months folloup (last updating) April 2002.
<www.stress-cocchi.net/Genetics5.htm>.
Cocchi R. A floppy child with
polymicrogiria and mental retardation. Report of the first four months of drug
treatment. June 2002. <www.stress-cocchi.net/mentret4.htm>
Cocchi R Twenty-seven months of antistress drug
therapy in a girl with partial trisomy 22. April 2003.
<www.stress-cocchi.net/genetics7.htm>
Cocchi R. Treatment with antistress drugs of a GM1
gangliosidosis, of probable intermediate juvenile-adult type.. July 2003. <www.stress-cocchi.net/genetics9.htm>
Cocchi R. Sialorrhea (or drooling) in Downs. An
epidemiological investigation on 510 Ss January 2004a <www.stress-cocchi.net/Down38.htm>
Cocchi R. Need we recover the clinical idea of an
individual resistance to illnesses? August 2003,
<www.stress-cocchi.net/Speculation4.htm>
Cocchi R. Drooling (or sialorrhea) in Downs treated
with primarily antistress drugs. March
2004b,<www.stress-cocchi.net/Down40.htm>.
Cocchi R. Drug therapy in an autistic child of 7 years
at the first consultation: the updated case history. May 2005
<www.stress-cocchi.net/Autism15.htm>
Leung AKC., Kao CP. Drooling in children. Pediatrics
and Child Health 1999, 4: 405-411.
Posted on Internet on November 2005. Copyright by Renato Cocchi 2005.
Author's address: dr Renato COCCHI, via Rabbeno, 3
42100 Reggio Emilia
renatococchi@libero,it
Drug modulation of stress reactions
Home Page / / / Pagina iniziale