Alternative cholinesterase inhibitors
 

Hello. Does anyone know if there are alternative cholinesterase inhibitors available that do not contain bromide? Particularly, is there a way for a doctor to order them from another country? I am in Canada. I understand that a drug called ambenonium chloride used to be available in the States and it was somehow possible to order it in Canada from there. But I understand that the States no longer carries it. Some countries in Europe seem to have it but I am unfamiliar with the rules with respect to a doctor from Canada prescribing a drug that is only available in another continent.

Thanks so much for any information/advice!

Hi Hopful

Welcome to NeuroTalk :).

The MG forum is very active so I am sure that you will get lots of support and helpful suggestions from other members.

Best wishes.

Hi, Hopful! Sorry, things are hectic lately.

Myletase was discontinued almost everywhere. Last time I heard, France still had the drug available. Too bad too, since it is more effective than Mestinon in some people.

Huperzine A and Ashwaganhda both have cholinesterase inhibitor properties like Mestinon does. But they are not regulated and dosing would be problematic. Ashwaganhda has other effects as well, and the plant should be run by a primary doctor before trying it, IMO.

Assessment of Cholinergic Properties of Ashwagandha Leaf-Extract in the Amnesic Mouse Brain

Caffeine also has cholinesterase inhibitor properties, but is not as good as plants.

Do you have issues with bromide? Some compounding pharmacies can make Mestinon without bromide. Do you have those in Canada?

There is lactose/dairy in the Mestinon tablets, which is not in the syrup. Are you sure the bromide is the issue?

I wish our country were more into Eastern medicine! We're just into big Pharma! :cool:

Does that help? Anything else we can do for you?!

:grouphug:
Annie

Thanks for the reply, AnnieB3!

Unfortunately, I've experienced excessively high bromine levels on several occasions- manifesting in a negative anion gap- with this medication. I suppose that I had what is called bromism. I'm not sure why I seem to have an issue with excreting the bromide. I think it could be due to its long half-life. But I don't seem to see this problem with other myasthenics, although there aren't that many of us.

I have looked into herbs. Huperzine seems a little promising, but I have concerns with its NMDA receptor inhibition. I don't know what the consequences of that would be with this disease, and at this point, it feels dangerous to take the risk. I absolutely agree that these supplements need more studying.

I'm not sure what to do at this point, but I will keep searching!

Thank you, AnnieB3