Has there been any further information on the questionnaire referred to in
this article?  If so would please forward it to me.
Thanks, Tom

----- Original Message -----
From: "Murray Charters" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Wednesday, February 04, 2004 4:57 PM
Subject: ARTICLE: Checklist Pinpoints When Parkinson's Drugs Wear Off


> Checklist Pinpoints When Parkinson's Drugs Wear Off
> 2004-02-04
>
> Doctors may be able to improve long-term outcomes by lessening symptom
fluctuations
>
> A new questionnaire tells doctors when medication is wearing off in people
with Parkinson's disease -- and may help
> them improve long-term outcomes.
>
> The disease's characteristic tremor and difficulty with walking, movement
and co-ordination are caused by a shortage of
> dopamine, a chemical messenger in the brain. One of the main treatments is
the drug levodopa, which is converted to
> dopamine in the body.
>
> But within the first few years of treatment, people receiving levodopa or
other anti-Parkinson's drugs begin to notice
> their medication lasts for shorter periods, causing symptoms to re-emerge
before the next dose.
>
> It is important for doctors to recognize this, because there are new
medications that can help improve symptom control
> throughout more of the day, says Dr. Robert Hauser, a professor of
neurology at the University of South Florida in
> Tampa.
>
> Hauser helped develop a simple checklist of 32 wearing-off symptoms that
Parkinson's patients can fill out themselves.
>
> In a study involving 289 patients with the disease, the questionnaire
detected wearing-off symptoms twice as often as
> an assessment by a specialist.
>
> While the standard clinical assessment identified wearing off in 85
patients (29 per cent), 165 patients (57 per cent)
> reported wearing off on the questionnaire. When asked about the
difficulties associated with these symptoms, 37 per
> cent categorized them as "very troublesome."
>
> While the questionnaire's ability to improve outcomes remains to be
tested, Hauser says detecting wearing-off symptoms
> earlier could be helpful.
>
> "It's thought these fluctuations (wearing-off symptoms) mostly come first,
and then later on down the road patients get
> the twisting and turning that we call dyskinesia as a result of the
fluctuating dopamine stimulation in the brain," he
> says. "So, it's possible that if we could identify them earlier and treat
them, perhaps long-term outcomes might be
> better by avoiding those clinical fluctuations."
>
> Doctors may be able to smooth out the fluctuations by changing the dosing
of the levodopa or combining it with other
> drugs, such as entacapone.
>
> Levodopa is also taken with carbidopa, which reduces its side-effects and
improves its effectiveness.
>
> SOURCE: The Medical Posting, Canada
> http://tinyurl.com/33wlp
>
> * * *
>
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