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From: "J.R. Bruman" <[log in to unmask]> Subject: Menstrual Fluctuation Factor, S.: Acetazolamide Therapy of Menstrual-related Fluctuations In Parkinson's Disease; Movement Disorders 1993;8:240-241 Acetazolamide (a drug originally developed to counter CO2 imbalance in acute mountain sickness) at 500mg/day "dramatically" improved monthly symptom fluctuations in a premenopausal PD patient. At time of writing, improvement had lasted 2 years. The article also mentions success of acetazolamide (Diamox) against a different case, of Essential Tremor. Further, controlled, trials are recommended. For a paper copy, send me a business-size SASE. Cheers, Joe J. R. Bruman (818) 789-3694 3527 Cody Road Sherman Oaks CA 91403 comment For those who speak Spanish there are several articles in Prensa Med Argentina by RAMOS, Angel, about acetazolamide and PD, with case studies, in men and women, including reversal of weight loss. Lower doses , less than 250 mg/day, are suggested, and one should watch standing blood pressure carefully. Tremor improved dramatically despite severe fall in blood pressure in the first case of a pilot controlled study, which got no further due to my lack of funds and possibly because the patent has run out, but mostly because the possibility of lower dose was not realised, and the mode of action, if any, seemed obscure. The video was quite dramatic, as impressive as any the surgeons showed. Using acetazolamide once a month is inherently safer than continuous use. Side effects include acidosis and potassium depletion. It stimulates breathing, so other breathing stimulants, including progesterune, may help. I speculated that PD might worsen as the level of progesterone falls, depriving the body of some respiratory drive. Women could study these possibilities, and technology to measure hormone levels is readily available. Those who start hormone replacement therapy might find a change in PD. One does not need to be an epidemiologist to see that PD is common post menopause, and I read that HRT takers may have less PD, one study for and one against, but it was in a news release and has not appeared in medline as far as I know. My own testosterone is down a little, and I speculated that anabolic steroids might help, but got no further. Women with PD should be outraged that their special needs have not been addressed. At least something is known of sexuality in men with PD, but nothing seems to be known about sexual response of women with PD. Men who take thioridazine, a dopamine antagonist, may suffer from difficulty maintaining erections, and premature ejaculation, as do some men with PD. One patient told me thioridazine made it difficult for her to climax, so perhaps PD has the same effect.