Table 2.

Double blind placebo controlled studies of topical and oral agents in hyperhidrosis.

Agent	Author and year	Type of hyperhidrosis	N	Study design	Class	Findings	Side effects
Topical Aluminium Chloride Hexahydrate 25% in Ethanol	Glent-Madsen et al., 1988	AH	30	Randomized, double-blind, half-sided experiment	III	25% aluminum chloride in ethanol alone was effective in all pts	Skin irritation
Topical Glycopyrrolate	Shaw et al., 1997	Gustatory (Frey’s syndrome)	13	Double-blind, PBO-controlled, crossover study	II	All pts experienced significant improvement. Glycopyrrolate reduced the sweat response to a challenge by 82% (p < 0.01). The frequency of episodes of gustatory sweating also reduced by 51% (p < 0.01), with a nearly 100% reduction in the frequency of severe sweating (p < 0.01)	Eczematous reaction in one patient
Topical Glycopyrrolate	Hays 1978	Gustatory (Frey’s syndrome)	16	Double blind clinical trial	III	Topical glycopyrrolate(0.5% and 1.0% ) abolished gustatory sweating for several days after single application.	No significant side effects
Topical 2% Diphemanil Methylsulfate (Prantal)	Laccourreye et al., 1990	Gustatory (Frey’s syndrome)	15	Double blind study	II	Partial relief in 33.3% and total relief in 40%. Duration of relief varied from 2 to 4 days.	Dryness of the mouth noted in two pts.
Oral Menthatheline Bromide (Vagantin)(systemic anticholinergic)	Hund et al., 2004	AH and PH	41	Randomized, PBO-controlled, double blind clinical trial	II	Mean axillary sweat production decreased in the treated arm from 89.2 ± 73.4 mg/min prior to therapy to 53.3 ± 48.7 mg/min during therapy (p = 0.02). No change in palmar sweat.	Dry mouth
Oral Menthatheline Bromide (Vagantin)(systemic anticholinergic)	Muller et al., 2012	PH, AH or Plamo-Axillary	339	Multicenter, randomized, PBO controlled trial, blinding not accurately described	II	50mg three times a day: improved DLQI, HDSS, and decreased mean axillary sweat production (p = 0.004).	Dry mouth frequently reported
Oral Oxybutynin	Ghaleiha et al., 2012	Hyperhidrosis secondary to Sertaline	140	double-blind, PBO-controlled	I	Improved HDSS in the drug compared to PBO group, p ≤ 0.05	GI and GU symptoms, sedation, dry mouth,
Oral Oxybutynin at low doses	Nelson et al., 2012	PH, AH, and plantar	50	Prospective, randomized, single blinded(patient blinded), PBO controlled	II	5mg twice daily caused moderate to marked improvement in PH or AH, (70%) versus 27.3% in PBO (p < 0.001). Moderate or great improvement in plantar hyperhidrosis (>90%) compared to 13.4% in PBO (p < 0.01)	Dry mouth (frequent) in 47.8%

PH: Palmar Hyperhidrosis; AH: Axillary Hyperhidrosis; PBO: placebo; pts: patients; DLQI: Dermatology Life Quality Index; HDSS: Hyperhidrosis Disease Severity Score.