question about med and cholinergic neuropathy
 

If I have cholinergic neuropathy, should I be ok to take doxylamine succanate? It says its an anti cholinergic drug?

If you have a true cholinegic neuropathy with extreme dry mouth, no sweating, and the profound GI symptoms, then you would want to avoid ANY anti-cholinergic medications, as it might intensify certain symptoms.

Doxylamine succinate is a powerful anti-cholingernic, it will worsen your symptoms, and its has a sedative effect. its very similar to diphenhydramine.
Doxylamine(which i have taken before i had my neuropathy), causes drowsiness, dry mouth, nose, eyes, it slows down your digestive system, and can lead to constipation. Im taking from my experience from taking diphenhydramine since it has identical side effects and sedative properties to doxylamine. its primarly used as a sleeping aid combined with Night time medication. It is also used uncommonly as a 1ST generation antihistimine.

Before my neuropathy began, which i believed that diphenhydramine had a hand in causing. I had been taking it for more than a month 1 pill a day, sometimes twice, Even if i was only supposed to take it only 10days, for allergies.
The side effects were unpleasant, they made me extremely drowsy, they dried out my mouth and nose(it reduced my allergies), and made my already slow digestive system slower and caused some constipation, and it gave me myclonic and hypnic jerks. I havnt noticed any reduced sweating but im pretty it was present. On another forum, someone said i could be having toxicity effects from DPH. the most unpleasant effect was the sedation, and the waking up from it. doyxlamine should not be taken more than once every 4 hours, peferably not over 10 days. choligernic neuropathy is a version of autonomic neuropathy, and 1st generation anti-histamines affect the autonomic nervous system.

There has been a study out recently from Harvard about anticholinergics and possibly causing Alzheimer's in the elderly.
This has caused considerable controversy.

As a result, The People's Pharmacy has a post online including lists of drugs that have anticholinergic properties.
http://www.peoplespharmacy.com/2015/...inergic-drugs/

The first generation antihistamines, are moderately anticholinergic. (not powerfully so). They will not stop GI spasms as a rule except in very high doses, and those high doses are not commonly used.

A strong anticholinergic is used for lessening gastrointestinal symptoms of spasms or bladder overreactivity. (these include atropine, dicyclomine, hyoscyamine, belladonna, scopolamine, oxybutinin)

The first generation antihistamines and antipsychotics are moderately anticholinergic. Taken regularly (like daily) these may be additive and become more like the the stronger ones, I listed, as the side effects may become additive over time. Taken in high doses for a long time, they may show more side effects, however.

I have used anticholinergics since my late teens, because I have a serious GI birth defect.( And I have used the first gen antihistamines too). Never daily, but only when needed to unravel a serious GI spasm so I use the strong ones. I have never had a problem with them except for a mild blurred vision and dry mouth occasionally over night. Even though I have a sensory neuropathy, I don't seem to have autonomic damage. If anything I have an overactive parasympathetic system.

So everyone is different and brings their own genetic DNA to the table when illness is concerned.

So for patients with a diagnosed cholinergic type of autonomic
neuropathy, the lists above from People's Pharmacy should be consulted whenever drugs are prescribed.

I will say that the second list, is not cast in stone. I think some drugs in it belong in the first list.
Lomotil contains ATROPINE is a strong anticholinergic.
Imodium also is pretty strong.
But others on that moderate list do not trigger the drug interaction warnings that pharmacies use for dispensing to patients. The insurance companies now stop RX dispensing for the elderly (over 50) requiring a pharmacist's override to continue the request. Most pharmacists do not counsel patients on most of these, however. Of all the anticholinergics used on RX, oxybutinin the the most commonly used in the elderly, for incontinence symptoms.

This is the study from the Harvard discussion:
http://www.health.harvard.edu/blog/c...k-201501287667
Notice Claritin is suggested to replace first gen antihistamines in this article-- but People's Pharmacy has it listed as "moderate".

So like most things medical, there is not a real answer for everyone equally.

Mrs. D,
I am amazed at that list and that I was prescribed so many of those drugs with my autonomic neuropathy. Maybe stunned is a better word.

1. Zanaflex was prescribed for my muscle spasms and literally put me on the floor and did not even lessen the spasms a tiny bit. My blood pressure went so low on it that I couldn't even sit up.

2. Baclofen was prescribed for the muscle spasms and it did nothing at all to help and only made me tired and more agitated.

3. Flexeril- same reaction as zanaflex and muscles as stiff as rocks

4. Nortriptylene was prescribed but I never tried it. That's on the list. I can't believe that the doctors would prescribe it if they have my test results and know what kind of neuropathy I have. This was on the list of possibilities for my treatment and I hadn't ruled it out yet.

5. Interestingly enough, diazepam is not on the this list, and although I hate taking it- I have to say that when I need it, it is a Godsend and keeps me out of the emergency room. I have no bad effects from it with my nervous system. In fact, it even helps with some of my autonomic systems when things are misfiring and causing muscle spasms or vasovagal problems.

Here is a better list:

Moderate to high given as well as LOW:

http://lbdtools.com/files/anticholin...he_elderly.pdf

You could ask your allergist about the molds used in the test.

When I had my allergy testing in the '70's I reacted to mold and mildew too. But I don't think "toxic" mold is included in that testing. But I am not sure.