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Note to Don Adams Thank you for your interesting observations on Requip and Sinemet, some of which are included below. Recently I downloaded a way-too-long Medscape article on levadopa studies, the end-result of a Jan. conf. in Austria. Researchers met to try to pull together all the info to date and subsequently issued a 46-page report (landscape format), which I haven't gotten into yet. I did save the consensus, and I'm forwarding it below. At least two pharmaceutical companies helped fund the meeting, and many of the researchers might have had grants and attendant biases. But a broad review of articles published, and listed in the bibliography, suggested some objectivity at work, despite the fairly surprising "pro" position. Levodopa: Why the Controversy? The Consensus The Consensus Statement Following the presentations of the evidence and ensuing discussions, the conclusions reached by the panel with respect to in vitro studies, in vivo studies, and clinical management of PD can be summarized as follows: In Vitro Studies Levodopa has the capacity to be both toxic and protective to dopaminergic neurons in vitro depending on the experimental conditions; It is unlikely that these studies have direct relevance to PD. In Vivo Studies Levodopa does not promote dopaminergic cell death in normal animals; Levodopa is not toxic to dopamine neurons in dopamine-lesioned animals in the large majority of studies; Levodopa is not toxic to dopamine neurons when administered in combination with oxidative stress; Motor complications are induced by pulsatile stimulation of dopamine receptors, which is related to both the severity of neuronal degeneration and the half-life of the dopaminergic agent employed; Levodopa-induced motor complications appear to be primarily related to the method of administration of levodopa rather than to the molecule itself; Administering levodopa in a more continuous, longer-acting formulation may reduce the risk of inducing motor complications. Clinical Studies Levodopa is the most effective antiparkinsonian drug; All PD patients eventually require levodopa; Levodopa continues to provide antiparkinsonian benefit over the course of the disease; There is no evidence that levodopa causes or accelerates neuronal cell death in PD; Increasing evidence suggests that the development of levodopa motor complications is related to the manner in which levodopa is administered, and delivering levodopa in a more continuous manner may prevent or ameliorate motor complications; The decision of when and how to prescribe levodopa should be based only on considerations of efficacy, the potential of the drug to induce side effects, and the individual patient's response to therapy. From: Don Adams Subject: PD Symptoms or Med Side Effects? For Dolores Buente: .....it is difficult or impossible to determine true benefits of taking the agonists. They undoubtedly help certain symptoms in one individual and provide no relief in another case. I do believe this right now.........The true PD symptoms I have are alleviated periodically by carbidopa/levadopa and I would never suffer side effects like I did in order to PERHAPS (remember there is controversy over this also...Drs are not Gods) stave off the inevitable long term debilitating effects of Parkinson's Disease. PD is a "designer disease" and some will have it progress faster or slower no matter what you do.... so..... does Sinemet actually hasten the "end game" of PD? Probably it does because the studies have been in progress so long and show it ---------------------------------------------------------------------- To sign-off Parkinsn send a message to: mailto:[log in to unmask] In the body of the message put: signoff parkinsn