Brian, will you say a little more about neuros who still believe in=20
delaying levodopa?  Maybe help me understand the pros/cons of =20
conservative/progressive approaches.  I'd sure be a lot happier at this=20
stage if I could get some more mobility in my left hand, and if this=20
clearly associated backache (which responds minimally to physiotherapy)=20
could be lessened.  But I too feel cautious about commencing other=20
medication (taking Eldepryl 10 mgs per day now).=20

Beth Leslie



On Sat, 7 Dec 1996, Brian Collins wrote:

> On Thu 05 Dec, [log in to unmask] wrote:
> > I had an assessment done recently due to the problems I was having with
> > Artane.  My cognitive funcitions were severely impaired.  I was sent to=
 a new
> > neurologist who recommend that I go on Parsidol ( Parsitan in Cdn Gener=
ic
> > name is Ethopropazine HCL.  It is only available in Canada.  Not becaus=
e it
> > is illegal but the pharmesuiticals in this country can't make a profit =
off
> > it.
> >=20
> > It works well without some of the Artane side effects  I take a 50mg in=
 the
> > morning and it lasts for about 2 hours.  It does an excellent job of
> > controlling the tremor but at the end of 2 hours you are not in very go=
od
> > shape.  I then take 1/2 a pill and that lasts for about an hour.  If th=
ey had
> > a CR version it would be helpful.  Has anyone else had any experience w=
ith
> > this drug?
> >=20
> > David Rohrbaugh
> > [log in to unmask]
> >=20
> >=20
> Hello David. I have had to dig quite deeply to find a reference to Parsid=
ol.
> It turns out to be another of the group of drugs known as Anticholinergic=
s.
> These drugs were popular in the days before levodopa was invented. It was=
=20
> found (literally by accident) that by inhibiting the amount of acetylchol=
ine
> in the brain, this=A0seemed to make way for the production of a little mo=
re=20
> Dopamine. You will detect that I am not exactly enthusiastic about these=
=20
> drugs, and you would be right, but I am only reflecting the view of the
> experts.  The more modern books refer briefly to the group, but does not=
=20
> recommend them. In short: They have a high 'Side-effects ratio.' (By whic=
h
> I mean the ratio of unwanted side effects compared to the effectiveness i=
n=20
> controlling PD symptoms.
>   I realise that there may be people out there who hav been put on to the=
=20
> anticholinergic drugs for a variety of reasons: You may suffer an allergi=
c
> reaction to levodopa: You may be in the early days of your PD, and are=20
> being trwated by one of the rapidly disappearing group who seem to think=
=20
> that it is a good idea to delay the introduction of levodopa for as long =
as
> possible (it isn't): Or you may be being treated by an MD.
>=20
>  whose last update
> on PD was in 1955. You may think that your treatment with which ever of=
=20
> these drugs you are taking has been satisfactory, so why change to
> something which is unknown to you? All I can say in answer is that Artane
> (of which I do have experience) and the rest may be coping at present, bu=
t
> PD never stands still, and it may be a very different story in a year or
> two. Meanwhile you are running a higher than necessary risk of side- effe=
cts,
> which to me is the decisive factor.
>=20
> You may well by now be feeling rather trampled-on, and are sitting mutter=
ing=20
> 'But I only asked about Parsidol' in which case I will get out of your ha=
ir.
> Be assured however, that I am trying to recommend what I really believe i=
s
> the best course of action for you.
>   I suggest that you try some of these points on your neurologist, and se=
e=20
> what he has to say
> Regards,
> --=20
> Brian Collins  <[log in to unmask]>
>=20