Hyperhidrosis medications: effective, but with a price

From sage to acetylcholine: a magic pill against excessive sweating?

The autonomic nervous system controls sweating in the human body. The neurotransmitter acetylcholine is responsible for transmitting nervous impulses to the sweat glands. This is where the therapeutic approach in drug therapy for hyperhidrosis begins. Anticholinergics are agents that suppress the action of acetylcholine in the nervous system. By taking anticholinergics, the activity of the sweat glands is thus blocked. The two anticholinergics approved in Germany for use in treating hyperhidrosis are bornaprine hydrochloride and methanthelinium bromide. Anticholinergics usually take 2 to 3 weeks to show results, since the dose must be slowly increased at the start of treatment.

Effective, but with side effects

The problem is that taking anticholinergics also suppresses other impulses in the body that are transmitted by acetylcholine, so not only is sweat secretion suppressed, but also the secretion of saliva, gastric juices, and bronchial fluids. There is also a decrease in the tone of the smooth muscles in the gastrointestinal tract, the urinary tract, and the bronchial muscles, an increase in heart rate, an increase in peripheral vascular resistance, enlargement of the pupils, and blurry vision possibly requiring premature use of reading glasses. Visual disturbances, stomach upset, severe dryness of the mouth, eye, and skin, constipation, urinary retention, and heart palpitations may occur as side effects.

Some illnesses, the use of certain medicines, as well as pregnancy and lactation are contraindications for treatment with anticholinergics. Since anticholinergic drugs require a prescription, an individual check-up with your doctor is always necessary before taking them.

Sage as cure for heavy sweating?

As an alternative to prescription anticholinergics, some people recommend using sage to prevent heavy sweating. It is believed that the essential oils of sage have a calming effect on the central nervous system that controls the sweat glands, thereby inhibiting sweat production. Sage supplements are widely available as tablets, drops, teas, or baths (which are recommended especially for the treatment of sweaty feet).

Other medications for sweating:

In rare cases, other medications can also help reduce excessive sweating. These include, for example, beta blockers. If stress and emotions are the cause of heavy sweating, psychotropic drugs can be used to calm the autonomic nervous system.

Will insurance cover drugs prescribed for sweating?

Once evidence of its medical necessity has been submitted, the statutory health insurance carriers in Germany will cover such medicines if prescribed, less the co-pay.

Benefits and risks of drugs compared to HIDREX iontophoresis treatment

Compared to taking medication, iontophoresis treatment is free from long-term negative side effects and delivers results directly to the area of skin being treated. Unfortunately, taking anticholinergics also affects other desirable processes in the body. The success of HIDREX therapy has been proven in many studies, whereas the effectiveness of alternative treatments such as sage have not been scientifically proven and results vary widely from individual to individual.


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