Quote:
Originally Posted by MAT52
I experienced it with Amitriptyline (worsening of Sicca) and Duloxetine/Cymbalta which dried my saliva ducts up significantly. Since coming off most medications I'm left with Dysguisa and dry eyes but neither seem to show up in routine tests anymore, since dropping these medications. Which leaves me thinking that the bad taste, changes in bowel habits/ digestion, itching (scalp and back) and Sicca must all be autonomic rather than the drying up of mucous membranes as you describe for yourself?
What I'm still very unclear about is that PoTS/ Dysautonomia can be secondary to Sjogren's amongst other connective tissue diseases. So how can we know which type of specialism these come under? Is it possible to have a type of Sjogrens that mainly presents neuropathicslly/ neurologically?
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MAT,
Yes, anticholinergics are number one on the list of medications...and Amitriptyline does have some anticholinergic effect, so it would be expected that you have this side-effect.
Autonomic neuropathy is a subset of PN, so I didn't list it separately, but yes, it can cause the dry mouth as well. But just as I stated above, the dry mouth/eyes would typically not be that severe unless other aspects of the neuropathy (peripheral or autonomic) are likewise that severe. I just don't think you'd have cracked tongue and peeling lips so bad that you can't swallow properly and not have severe BP instability, POTS, or severe PN pain at the same time. Dry mouth/eyes IS a symptom of PN, but not a prominent one, I guess is the best way to describe what I'm saying.
Actually, you are exactly right about 'types' of Sjogren's being different and having one that presents with neuropathy. The type of Sjogren's I have has specifically attacked the dorsal root and autonomic ganglia, so I presented with neuropathy symptoms before the typical Sjogren's symptoms. They call it Neuropathic Sjogren's.