Mestinon and Promethazine together?

[emmablondevoyage]

I have been taking Mestinon (prescribed by cardiologist).

I believe Mestinon is a Acetylcholinesterase inhibitor which means it works by decreasing the breakdown of the neurotransmitter acetylcholine, therefore, increasing levels of acetylcholine which increases the parasympathetic nervous system and in theory potentially improve CFS symptoms.

The psychiatrist I see has prescribed Promethazine which is an anti-histamine and can also be used for sleep, stress etc. From what I've read Promethazine is anticholinergenic, which means it blocks the action of acetylcholine and inhibiting parasympathetic nervous system activity. Does this mean it might worsen CFS symptoms?

Does this mean that the medications Mestinon and Promethazine might cancel each other out? Any thoughts on this?

Have you tried both of these together? If so, what was your experience like? Thank you!

 

[DonPepe]

I’m new on Mestinon, and thus far I’m very happy with my improvement over the last week or so.

Your question deserves a lot of thought.

Are you taking Mestinon now? Are you improving on it?

If you are taking it now and improving, then if it was me I would wait until your improvement plateaus out before considering the Promethazine.

But there are far cleverer people in PR than me. Hopefully you’ll get some considered opinion over the next few days.

 

[Wayne]

Have you tried both of these together? If so, what was your experience like? Thank you!

Hi @emmablondevoyage -- Unfortunately, I have had an experience with Promethazine (just a a single dose), and it was a VERY difficult one. I wrote extensively about it in the following thread:

Need Advice - Having Very Adverse Reactions to Promethazine (Phenergan)​

That was over 6 years ago, and I'm still experiencing the fallout from that. So many of the things I experienced then, and some that I still do, are all side effects that have reported by people taking this. One of the most serious is "psychotic episodes". You'd think a doctor would mention this when recommending a person take it, but for some reason, doctors usually gloss over potential "side effects", even when they can be life altering, as was the case for me. I'm still left with tinnitus, vertigo, and akathisia (and more), all difficult to deal with.

I believe Mestinon is a Acetylcholinesterase inhibitor which means it works by decreasing the breakdown of the neurotransmitter acetylcholine, therefore, increasing levels of acetylcholine which increases the parasympathetic nervous system and in theory potentially improve CFS symptoms.

I've never taken Mestinon, but am quite familiar with the concept of decreasing the breakdown of acetylcholine. I take a supplement called Huperzine A (I think it's a naturally occurring moss), which inhibits the enzyme that breaks down acetylcholine. As soon as I started taking it, I noticed my attention span while being on the computer improved significantly. So in my situation, I'm able to get the benefits that are being sought from taking Mestinon without having to take a drug (which is my preference).

I recommend doing a lot of research on Promethazine before agreeing to give it a try. If you do decide to give it a try, I would also suggest starting out with a VERY low dose in case you have any kind of negative reaction to it. BTW, the psychiatrist who recommended this to you without explaining all the potential "SIDE EFFECTs" does not strike me as being very professional.