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Dear Friends, I am Peggy Rifleman, the sister of a 72 year old woman who has had Parkinson's for at least 12 years. I apologize for this long introduction, but I am desperate for information. My sister started on levadopa and carbidopa (sinemet) in the beginning and I searched the internet for information about the disease. I ran into a person who charted his medicine and food and found the best amount of medicines and when to eat without disturbing his symptoms. Perhaps he is a member of this list. I could not get my sister to try the system--she just takes the medicine given to her by the doctor and has been bumbling along all this time until last year when her symptoms seemed to take a turn for the worse. She was having trouble moving and she heard about COMT inhibitor and mirapex. The first day she started taking mirapex, she walked a mile and quarter without any trouble and then walked back. She was doing for well for the entire year, but now something is wrong. She is bobbing, bobbing so bad that her neck is being jerked and she has to hold her head. The doctor at my urging cut down her levadopa--she was taking it 4 times a day. He cut it to 3 times a day and then cut the midday levadopa to 1/2 pill. she takes the mirapex 3 times a day. I understand the biochemistry of levadopa levadopa crosses the brain barrier in the amino acid channel (thus protein inhibits the crossing) and then leva is cut from the dopa which makes muscles move. There is an enzyme in the blood that cuts the leva from dopa before it can get to the brain barrier--the carbidopa inhibits that enzyme. She is also now taking the COMT inhibitor with the sinemet which also inhibits that enzyme. Then she is taking Mirapex, which is a dopa agonist which means it competes with dopa for the dopa receptor and delivers approximately the same result as the dopa. Agonists may lead to new neurons or at least they may not destroy neurons as it is thought leva dopa does. The doctor said the idea is to get her on the lowest amount of dopa and the best amount of mirapex. The doctor also said he was trying to balance the dopa and cholinergic amounts or something like that.. In the first 10 years, the doctor hasn't suggested any other regimen of medicines until she asked for Mirapex. Yet there are a myriad of medicines out there to choose from, one of them reduces bobbing and that is Amantadine. Why didn't the doctor prescribe that? What are anticholanergic medications? I would like a plan. How can I approach all these medicines that are out there for Parkinson's? And find the best regimen for my sister? I need all the help I can get. Thank you for allowing me to share this list with you. Peggy Rifleman ---------------------------------------------------------------------- To sign-off Parkinsn send a message to: mailto:[log in to unmask] In the body of the message put: signoff parkinsn