The chemical substances for treatment of hyperhidrosis that require a prescription include the pharmacological group of anticholiner-gics. Their secretion-inhibiting potential is based on the interplay of sweat glands and cholinergic nerves. The active principles of the anticholinergic substances, also called cholinergic blockers, inhibit the function of sympathic nerve fibers governing the activity of the eccrine glands by blocking the receptors on the secretor cells of the sweat glands.
Upon stimulation of the hypothalamus, the messenger substance acetylcholine is liberated at the ends of the cholinergic fibers, which is important for sweat secretion. Acetylcholine has the function of binding to the secretor cells and activating secretion by the sweat glands via complicated biochemical processes. This transmitter is presumably also responsible for activation of the electrolytes, which perform an important function in the perspiration cycle and stimulate secretion by the sweat glands.
By occupying the receptors in the sympathic ganglia with anticholinergic substances, this reaction is suppressed, so that the extent of the secretion is reduced. The excess transmitter substance is ultimately decomposed by the enzyme cholinesterase into its constituents choline and acetic acid and thereby deactivated.
The best-known active principles among the anticholinergics include bornaprine hydrochloride, atropine, scopolamine, banthine, and propantheline bromide.