Anticholinergics are drugs that can be used to treat primary and secondary hyperhidrosis. Anticholinergics control excessive sweating by preventing the neurotransmitter acetylcholine from sending signals to the sweat glands of the sympathetic nervous system. Anticholinergics block the sweat glands from producing excessive perspiration.
Anticholinergics are prescription drugs in the US. While these drugs have not been specifically studied and prescribed for hyperhidrosis treatment, physicians however have discovered that they can be helpful because of their ability to inhibit the activity of neurotransmitters affecting the response of sympathetic nerves.
Some examples of oral anticholinergic drugs are:
- Glycopyrrolate (brand name : Robinul/Robinul-Forte)
- Oxybutynin (brand name: Ditropan)
- Propantheline (brand name: Probanthine)
- Benztrophine (brand name: Cogentin)
Glycopyrrolate is a widely used anticholinergic for hyperhidrosis. It has little or minimal effect to the brain and is safely used to inhibit the neurotransmitters from stimulating the sympathetic nerve impulse connected to the sweat glands. Using glycopyrrolate reduces perspiration but side effects may occur such as hazy vision, nausea, stupor, dry eyes and mouth including bloated stomach and constipation.
Oxybutynin is used for anti-depression induced hyperhidrosis. Cases of excessive sweating in patients have also been linked to anxiety. About 14% of patients using tricyclic antidepressants have manifested excessive sweating, and oxybutynin is an anticholinergic drugs that can treat the problem. Dr. Grootens of Netherlands have prescribed oxybutynin maintenance to his patients with depression. If this is the case, then adding anticholinergic oxybutynin to antidepressants can prevent hyperhidrosis. Some common side effects of oxybutynin are constipation, urinary retention, dilated pupils and blurred vision.
Propantheline comes in tablets and is used to treat cramps and spasms of the digestive system or the bladder but is sometimes given to patients with hyperhidrosis. Like other anticholinergics, propantheline bromide reduces the sympathetic response for sweat glands to over secrete. When taking this drug, it is important to maintain normal temperature because the cooling function of the sweat glands is also weakened.
Benztrophine is an anti Parkinson’s disease drug. People taking this drug have decreased sweating and the ability to cool the body is also lessened. An important component in beta blockers, benzodiazepines may help reduce stress-related sweating or emotionally-induced hyperhidrosis. Side effects of these anticholinergic drugs include dryness of the mouth and skin, blurred vision resulting to disorientation, drowsiness and nausea or vomiting, constipation and irritability, increased heart rate, as well as urinary retention.
When excessive sweating is on a small region of the body, gels, lotions and creams can be applied to the specific area where excessive sweating is observed. These topical solutions containing anticholinergics, such as glycopyrrolate, can be applied as in the case of gustatory sweating resulting from diabetes.
Physicians have discovered that these drugs are effective hyperhidrosis treatment but to be taken when necessary. If a patient can tell that a certain situation will lead him to perspire excessively, then he can take anticholinergics. However, if his sweating needs to be controlled on a daily basis, anticholinergics can be maintenance drugs to prevent any discomfort or embarrassment especially in the workplace. But this can also be taken in addition to any medication that he takes for existing illness like hypertension, diabetes, angina, hyperthyroidism, spinal injury and certain neurological problems like depression.
Hyperhidrosis can affect a person’s self-esteem and personality. If this disorder remains untreated, the effect can be emotionally damaging to the sufferer. Some sufferers whose hyperhidrosis started early in their childhood have sought all possible remedies such as antiperspirants, deodorants, Botox, surgery and anticholinergics to restore their self-worth and gain social approval.