Pharmaceutical Treatment of Sjögren's
Few pharmaceutical treatments have shown efficacy for Sjögren's syndrome. The most common regimen includes drugs known as cholinergics as well as interferon-alpha (Venables 2004). Cholinergics activate the parasympathetic system by mimicking acetylcholine, a neurotransmitter that stimulates the lachrymal and salivary glands. The 2 cholinergics prescribed most frequently are:
- Pilocarpine. Pilocarpine has been shown to reduce symptoms of xerostomia (dry eye). It can cause gastrointestinal upset (Nusair 1999).
- Cevimeline. Cevimeline (30 mg) taken three times daily seems to be well tolerated and provide substantive relief of dry eye. Twice that dose was associated with an increase in the occurrence of adverse events, particularly gastrointestinal tract disorders. Cevimeline taken over prolonged periods or in too high doses can cause drowsiness, excessive sweating, interference with night vision, as well as more serious side effects (Fife 2002).
Interferon has also been used in the treatment of Sjögren's. Among patients with primary Sjögren's syndrome, interferon has been shown to improve salivary output and decrease complaints of xerostomia without causing significant adverse medical events (Yamada 2005).