Systemic Medication: Propantheline for hyperhidrosis in spinal cord injury
The autonomic dysreflexia seen in patients often years after spinal cord injury can often lead to hyperhidrosis. Two patients with quadriplegia had excellent control of excessive sweating with use of the anticholinergic propantheline. When used at doses that treat neurogenic bladder, also seen in spinal cord injury, propantheline can be expected to also block the cholinergic receptors involved in sweat gland stimulation.
Another agent found useful for treating the hyperhidrosis associated with spinal cord injury is the opioid propoxyphene. Two patients with excessive sweating due to spinal injury of different duration and location had a dramatic reduction in sweating when given propoxyphene. Propoxyphene may work by a weak ganglionic blocking agent, reducing sympathetic tone to the eccrine sweat glands. A search of the medical literature using PubMed, however, found no further recent published reports of these medications in the treatment of hyperhidrosis.