There has been a lot of discussion recently (John Cottingham, Linda
Herman, Jim Ryan, Dinah Tottenham, Joe Bruman, et 'al) about the 12/16/95
BMJ article postulating increased mortality rates for people using
combinations of Levodopa and deprenyl (Eldepryl). It appears that the jury
is still out on this one but I'm sure it tweaked a deep inner response in
all of us who have been using it for some time (personally, since 1989).
I've been through all my references with regard to this topic and one theme
recurs in all of them..."concurrent administration of levodopa and an
MAO(Monoamine Oxidase) inhibitor (deprenyl) produce agitation and
hypertension (abnormally high blood pressure)".
It's interesting that the BMJ article doesn't indicate the cause of death
in those people who contributed to the "increased mortality" postulate.
Could it be that the majority of these people were hypertensive prior to
their use of the levodopa/deprenyl combination? If this thesis was borne
out, the problem could be minimized by contraindicating this drug
combination for people with existing hypertension
My neurologist is acutely aware of this levodopa/deprenyl hypertension
notion and very carefully tracked my response prior to approving continued
use of deprenyl. His postulate regarding the continued use of deprenyl after
starting levodopa therapy is... when levodopa is converted (decarboxylated)
into dopamine there are several neurotoxins produced as by products
(hydrogen peroxide is one). Deprenyl may provide some level of continued
protection against other of these neurotoxins that resemble MPTP which was
the alleged culprit in the original Tetrud/Langston DATATOP study (Science,
August 1989, pp519-522).
Additionally my drug references indicate... "Hypertensive crises have
been noted in situations with patients using MAO inhibitors and ingesting
cheese (especially aged cheeses), beer, wine, pickled herring, snails,
chicken liver, yeast, large quantities of coffee, citrus fruits, canned
figs, flava beans, chocolate and cream and their products. (Isn't that a
weird list of foods??? Weird may be the wrong word... ALL my sin foods are
on that list!) So there's another possible link to chase, i.e., were most
the people in the study group using the drug combination hypertensive men
with beer bellies, flava bean stains on their teeth, and the scent of
pickled herring on their last breath?
If any of you have access to any of the investigators that participated
in the British study it might be enlightening to try prompting them to
publish a sequel to their article that addresses the cause of death in their
study group. I shared this thought with Marvin Giles (Puppy^) on the
Parkinson's chat channel last night and he had come to a similar conclusion.
(I think I interrupted his viewing of the Super Bowl with my questions: and
for that I apologize :( , Marv) If that fails, perhaps we could prepare a
group letter to that effect.
What are your thoughts??
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David Barthuli
76H Coffin Avenue
Haverhill, MA U.S.A.
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(508) 521-0879
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