Hi Ervin,
Just to clarify, I think that the authors of the
articles do *not* believe that levodopa makes Parkinson's
worse, but they disagree on whether levodopa likely causes
problems like motor fluctuations. I think they use the term
"toxic" in several different ways, and that can be a bit
confusing. But for me, a key phrase was Weiner's "Currently
there is no evidence that levodopa use irreversibly damages,
destroys, or harms dopaminergic cells in patients with
Parkinson disease."
These articles don't challenge the recommendation to
"start low, go slow" with levodopa though, to avoid side
effects and in case research does prove that the drug
eventually stops working for people and/or causes
irreversible problems. As Shulman's article explains,
dopamine agonists and COMT inhibitors can be used to cut
down on levodopa use -- even without definitive research
results -- on the theory that it probably will help and
probably won't hurt. Have you talked with your doctor about
these other drugs? I don't think my father's neurologist has
ever suggested anything like that, and I wonder why not.
I don't take anything for my tremor, but my father is
taking Sinemet and he is worried about what it might be
doing to him. He tries to skip one of his three 25/100
Sinemet doses when he's having a low-tremor day, despite his
neurologist's disapproval. (Is this OK? I don't know.) He
read somewhere that Sinemet destroys brain cells, so these
articles should at least relieve that worry.
Hope this is helpful. I am interested in
non-pharmaceutical measures too. Who is Dr. Malkmus? Best
wishes.
Roxanna
On Sat, 18 Mar 2000 Ervin McCarthy <[log in to unmask]>
wrote:
>Roxanna, I read your references to toxicity of levodopa and
>more confused than ever. As a new participant to levodopa
it is
>noteworthy that they suggest the possibility of earlier
progression of the >disease when using levodopa. Are you
using it and what strength? >Always looking to learn. I
have been pursuing natural therapies like Dr.
>Whitaker and Dr. Malkmus. Best wishes.
----- Original Message -----
From: Roxanna Nakamura <roxynEARTHLINK.NET@>
To: <[log in to unmask]>
Sent: Thursday, March 16, 2000 1:25 PM
Subject: Levodopa toxicity a myth?
> I just came across these interesting new articles in the
> AMA's Archives of Neurology:
>
> "Is Levodopa toxic?" by William J. Weiner, M.D.
>http://archneur.ama-assn.org/issues/current/full/ncn8639.html
>
> "Levodopa toxicity in Parkinson Disease: Reality or Myth?"
by Lisa M. Shulman, M.D.
>http://archneur.ama-assn.org/issues/current/full/ncn8638.html
>
> "Levodopa toxicity" by Vladimir Hachinski, M.D.
>http://archneur.ama-assn.org/issues/current/full/ncn8640.html
>
> Despite the titles, these articles are encouraging.
> Apparently, research does *not* support the theory that
> levodopa hastens disease progression or cell death. On the
> contrary, levodopa extends life and decreases disability.
> The real "toxicity" concern, the authors say, is
whether/how
> levodopa really is related to motor fluctuations and
> dyskinesia.
