The following drugs may help reduce symptoms: For spasticity, baclofen For cramps, quinine or phenytoin To decrease saliva production, a strong anticholinergic drug (eg, glycopyrrolate, amitriptyline, benztropine, trihexyphenidyl, transdermal hyoscine, atropine) For pseudobulbar affect, amitriptyline, fluvoxamine, or a combination of dextromethorphan and quinidine In patients with progressive bulbar palsy, surgery to improve swallowing has had limited success.