Here's a helpful site that explains how anticholinergic drugs work. They block acetylcholine receptors. Too much acetylcholine causes muscle contraction as we have learned. Our natural cholinesterase enzyme, cleans up the excess acetylcholine.
From webpage: here's what cholinesterase does naturally
"The transmitter is either broken down by enzymes (10%) and removed or taken back up again into the nerve ending (i.e. recycled) - a process known as re-uptake."
and
"
the less dopamine activity you have in the extra-pyramidal system, the more acetylcholine is released in the muscles. Acetylcholine is the transmitter in the synapses of the muscles which make them contract. If you block dopamine in the extra-pyramidal system, you get more acetylcholine in the muscles, so they tighten up. Neuroleptics can thus block your ability to relax your muscles. So, your muscles can't relax and stiffen up and you get stiffness, tremor etc.
Anticholinergic drugs (such as procyclidine, benzhexol, benztropine, orphenadrine etc) block the acetylcholine receptors in the muscles, and reduce the effect of having too much acetylcholine, so your muscles are able to relax;"
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Now i have to go look up the link again. I have heard that anti-cholinergic meds do not have bad side effects. But Cogentin gave me brain fog. Recently an article did come out saying something about anti-cholinergic drugs causing dementia or cognitive loss. They may know this, but i don't take an anticholinergic for any of the reasons talked about. It relieves my leg weakness that I wonder about coming from too much acetycholine. I was wrapping my legs in ace bandages to be able to hold myself up steady and walk. Nortriptyline takes it away, and other benefits are extra, including an antidepressant function and a nerve pain killer.
lindy your dystonia might be an excellent way of telling if the patch works or not. do you see any pattern to your dystonia? at certain points of your med cycle are you more cramped than others? med changes are very difficult. When merck [europe] began playing with sinemet availability, did anyone even think about how hard it is for pwp to quit or change anything? I am sorry to hear about the withdrawal.... Can you start another med at the same time as you titrate down? Maybe you could google that question.
Cogentin made me feel better than anything [took it before i got the muscle weakness]. I could actually relax [pre-sinemet - i was on eldepryl and maybe mirapex by then. I would take it again....the brain fog might be the lesser of the evils someday.
http://www.nmhct.nhs.uk/pharmacy/moa-proc.htm
I learned a lot from this site, which is copyrighted 2008