Anticholinergics

In a healthy brain, dopamine coexists in balance with another neurotransmitter called acetylcholine. When this equilibrium tips in acetylcholine’s favor, dopamine production slows or stops, causing certain Parkinson’s symptoms. By reducing the amount of acetylcholine in the brain, anticholinergic medications can improve balance and reduce symptoms such as tremor, drooling, and some rigidity. Dosage must be carefully adjusted for age and weight. Elderly and thin people often cannot tolerate large doses. Even in small doses, anticholinergics can induce memory impairment and disorientation. Other side effects include rapid heartbeat, vision problems, constipation, urinary retention, and severe dry mouth.

These effects subside when the dose is lowered or the medication stopped. Anticholinergics include benztropine (Cogentin), biperiden (Akineton), procyclidine (Kemadrin), and trihexyphenidyl (Artane).
http://www.health.harvard.edu/newsle...n8217s_disease

I survived with acceptable quality of life using mucuna , kemadrine and supplements. i started kemadrine about a year ago which seemed great in reducing my tremor in the begining but my tremor is back now and I am looking for some thing else. any ideas?
imad

Hi Paula, I haven't read the entire thread so I don't know if this was posted.

All anti-cholinergics are not the same. I take trihexyphenidyl. It blocks a particular type (m1) of muscarinic acetylcholine receptor in the brain.

Unfortunately, it impairs short term memory, so I take as little as possible, just 1 mg twice a day. It helps with my dystonia. I take a few other anti-cholinergics for other problems, and they don't help my neurological symptoms at all, with the exception of baclofen.

imark,

i was reading through this and realized you were asking for something. Are you outside the U.S.? I didn't recognize 'kemadrine' so can't be sure ... . It definitely sounds an anticholinergic. Do you know if it is similar to Artane?

I know a few people who have used cogentin and nortriptyline for tremor. Cogentin was wonderful for relaxing the rigidity but caused a serious mental fog while on it. These are older drugs and have mental effects that are pretty significant. Nortriptyline is helping me a lot with a few things. It took away the peripheral weakness in my lower legs. It is an antidepressant [not sure they know why or how] and is a nerve pain killer.
But it seems that Artane is prescribed to many - is that for tremor? I don't have tremor.

Don't know that I helped, we need more choices!
paula

thank you paula. Kemadrine is an old drug which is in the anticholinergic class.
it was recommended for me by a psychotherapist friend of mine who is not a specialist in pd when i wad first diagnosed 3 and half of year ago. however, i started taking it only when my tremor became annoying about a year ago. when i last saw my neurologist in Jordan, he told me that Kemadrine is an old drug surpassed by new drugs and it is specially troublesom for older people like me.
he recommended to start sinemet which is the "real" drug fo pd. he also told me that the usefulness of kemadrine will wane of in about a year. in this , he was right.
since then I moved from jordan to calgary , canada about 6 weeks ago and i am experiencing the boons and faults of health insurance system. i think i have to wait a long time before seeing a neurologist.
imad
p.s. :by the way, i m signing by my first name now instead of imark which is a combination of my first, middle names and surname.

Here in the U.S. Kemadrine has been discontinued as of July 2009. It is replaced by the drug benztropine. I found this when I was prescribed Kemadrine to help control my tremor. I did not have much success using it or trihexyphenidyl for tremor control. Other people in my PD support group use one or the other with great success.

GregD

Pesticides cause damage to the autonomic nervous system by inhibiting acetylcholinesterase. Acetylcholinesterase is an enzyme in nervous tissue, muscles and red blood cells that causes the neurotransmitter acetylcholine to break down into parts that can be readily excreted. The accumulation of in the body of acetylcholine causes over-stimulation of acetylcholine receptor sites in both the central and peripheral nervous systems. High acetylcholine in the brain causes sensory and behavioral disturbances, poor coordination, depressed cognition and depressed respiration.

Pesticides act as irreversible acetylcholinesterase inhibitors by binding cholinesterase so that the enzyme cannot do its job. This causes a build up or over-accumulation of acetylcholine. Too much acetylcholine causes one or more of the following symptoms resembling a panic attack to develop: tingling or burning hands and feet, feverish or flushed feeling, blurred vision, dizziness or lightheadedness, a feeling of choking, heart pounding, shortness of breath, nausea, faintness, excessive sweating, ringing or buzzing in the ears, or feeling excessively hot or cold.


Pesticides cause damage to the autonomic nervous system by inhibiting acetylcholinesterase. Acetylcholinesterase is an enzyme in nervous tissue, muscles and red blood cells that causes the neurotransmitter acetylcholine to break down into parts that can be readily excreted. The accumulation of in the body of acetylcholine causes over-stimulation of acetylcholine receptor sites in both the central and peripheral nervous systems. High acetylcholine in the brain causes sensory and behavioral disturbances, poor coordination, depressed cognition and depressed respiration.

Pesticides act as irreversible acetylcholinesterase inhibitors by binding cholinesterase so that the enzyme cannot do its job. This causes a build up or over-accumulation of acetylcholine. Too much acetylcholine causes one or more of the following symptoms resembling a panic attack to develop: tingling or burning hands and feet, feverish or flushed feeling, blurred vision, dizziness or lightheadedness, a feeling of choking, heart pounding, shortness of breath, nausea, faintness, excessive sweating, ringing or buzzing in the ears, or feeling excessively hot or cold.

http://www.naturescountrystore.com/p...dpanicattacks/

.....unless anyone can provide a reason that i would be incorrect with the biology. i was not even good in chemistry,. in high school i was happy to be in chemistry class because the best looking guy in the school sat two seats in front of me and i know the back of his head very well. But the teacher had us call out our grades for him to record them in his gradebook. i guess that was faster but if it was to motivate us to do better it didn't work. i was in a high track so with the valedictorian in the class and i was in the last seat - i mumbled my usual D with some embarrassment. My friends made fun of me when i worked up to potential. ok there's more transparency than you needed to know but i think this is extremely important and can be resolved if there are reasonable answers to just a couple of questions.

Acetylcholine is the chemical messenger that alzheimers patients need. it is important to balance the transmitters. Dopamine is the missing chemical that parkinson's patients need. Acetylcholine is normal in pwp.

So why are they giving people with parkinson's aricept and exelon? probably others as well? the FDA has approved these drugs for parkinson's. these drugs specifically increase aceptylcholine and the effects of too much aceptylcholine are vastly understated....dangerously underestimated.

Do pwp need acetylcholine when they are quite elderly like anyone else? is there a lack of acetylcholine in the elderly in general? if not, there is no reason to give a ;pwp alzheimer meds and i think it could kill them.....may already have.

i may try to look this up but i remember last year when i ran away to pennsylvania [have reason to understand that behavior now] i posted in here that sometimes i just felt like 'nothing" - like i wasn't there....like i was just going to stop.

As many of you know, i almost got the mri for a DBS, checked out duodopa and neurologix for me , not to save mankind. saving mankind is undertstood. if we don't save ourselves it won't be our fault. But when disability advances, you want a clinical trial that is possibly going to help significantly and i wasn't ready for duodopa and any brain surgery is, imho, unsafe. DBS is approved but not altogether safe.

so i kept getting worse. jaye and carey visited and i know they were taken aback by my condition. i was vastly underweight and transforming each day into a rambling schizo with a beak mouth and slurred speech. i figured i was dying and wouldn't make it too much longer and moaned and whined in here for a long time to the disappointment of other posters sometimes. i couldn't explain my behavior, or figure out why i would do things or say things that were detrimental to me. But, on the other hand, several of the issues were vald. i just wasn't handling them well and my feelings of self worth hit an all time low.

luckily, i am also inspired and driven. so i plunked out that video for 23 and me, going downhill physically the whole time. when the topic of writing a book came up i immediately said, i don't want to lead it , i just want to consult. then, out of nowhere come conductor 71. pkell [who returned after years] and kath, an attorney,[violet green],along with the regulars who are involved. All so talented, lindylanka knows how to format a book, laura is extremely knowledgeable about things that come up , john is storing it online, girija is our scientist, jaye is a brilliant writer with soul, peg and linda h are long time activists and bandido bob is the commander. kath is an attorney....this group is producing and it's wonderful a graphic book that is written so that you can open it anywhere and read and learn something and we are writing the book right now in this forum. but i didn't know if i could do it.

i was still very weak, having panic attacks which i didn't have for most of my time with pd. ..just the last few years. i ended up in the hospital once. it happened in the evening if i went off then i would realize i hadn't eaten again and my legs would get so weak it was like i couldn't feel them. then panic and dystonia, along with that awful feeling that my legs weren't there.

i bought a shower chair, used a walking stick and never felt good, ifelt like i could just stop.

Then I remembered after hearing another member say she went on nortriptyline and felt better - that i had taken it pre sinemet -distinctly remembered the weak feeling in my lower legs that i was having again now so i went to the neuro and asked him for it. Told i would have to give up azilect, i commented, "oh that's shame, only 1/2 tab a day keeps me sharper and focused.."..lord knows i needed all the help i could get. iwas waking up in the middle of the night and waking my husband up to just be with me until i took meds and got rid of the panic, dystonia and weakness .

ok i know this is a repeat, but i have a feeling repetition is the only way i can get the right person's attention. if there is an explanation i need it .....that's all. otherwise we all have a problem.

my neuro [actually his PA or nurse practitioner ] suggested aricept for the cognitive symptoms and said she would then add nortriptyline. which she said was for nerve pain. i just remembered that it helped before and wasn't there for cognitive med like alzheimers patients need but i went into good patient mode and accepted it, unknowingly taking exactly what i didn't need.

for 3 days i suffered thru aricept and feel that i would have died of heart failure if i continued. it made my entire body weak like the legs and i couldn't breathe. that brings me to the difference between alzheimers and parkinson's and it's a big one.

i'm starting a new reply to review everything in a list of what i have learned since then. hopefully this is the last recapt of my experience and hopefully you can see and remember [unfortunately for me] how brain illness and medicines can affect your behavior. or maybe it is just part of the process that drives me. i have always felt like something else is going to happen. i felt that way from meeting mike, but now i have finally gotten around that and am going forward on my own. things are still happening that just amaze me. and the fact that these drugs are given to pwp - unless someone explains it to me....is mind blowing.

or i could just be so full of drugs that i am delusional.

...if you have too much of it. i am going to list my resources at the end. i've got them.

I have to explain chemical messengers and am doing so cautiously. dopamine and acetylcholine must be balanced. in pd the dopamine is low, in alzheimers the acetylcholine is deficient. Aceptylcholine is regulated by esterase, an enzyme that breaks it down and keeps it low - i am going to call it the cholinergic enzyme but that may not be chemically correct. anticholinergic drugs. help to keep the acetycholine low as well. It needs to be low as it is excitatory. THese act as our natural cholinergic enzyme would. we need to use them when our own do not work.
But what if something happens to the enzyme. then a build up of acetycholine occurs. And what could cause something to happen to the enzyme? pesticide poisoning. Then you get too much acetylcholine, which can lead to paralysis, bradycardia [heart muscle] difficulty breathing, muscle cramping [i'm wondering if it is completely responsible for dystonia], tremor, faintness,light headedness, poor food absorption, and even death. It cause sensory and behavior disturbances, especially paranoia.

why would we need a drug that blocks this enzyme to allow more acetylcholine in pwp? just because we both have cognitive difficulties. no....we don't have the severe problems that alzheimers patients do. we have mild cognitive impairments and people in nursing homes who cannot communicate how this med is making them feel could die.

i need a break but i am far from finished. feel free to jump in and set me straight.

otherwise i'll be back after more meds.

Pesticides cause damage to the autonomic nervous system by inhibiting acetylcholinesterase. Acetylcholinesterase is an enzyme in nervous tissue, muscles and red blood cells that causes the neurotransmitter acetylcholine to break down into parts that can be readily excreted. The accumulation of in the body of acetylcholine causes over-stimulation of acetylcholine receptor sites in both the central and peripheral nervous systems. High acetylcholine in the brain causes sensory and behavioral disturbances, poor coordination, depressed cognition and depressed respiration.

Pesticides act as irreversible acetylcholinesterase inhibitors by binding cholinesterase so that the enzyme cannot do its job. This causes a build up or over-accumulation of acetylcholine. Too much acetylcholine causes one or more of the following symptoms resembling a panic attack to develop: tingling or burning hands and feet, feverish or flushed feeling, blurred vision, dizziness or lightheadedness, a feeling of choking, heart pounding, shortness of breath, nausea, faintness, excessive sweating, ringing or buzzing in the ears, or feeling excessively hot or cold