 |
 |
Just a footnote to your summary discussion: a) Regarding hypertensive crises due to interaction with levodopa, these relate to MAO-A inhibitors, which work elsewhere than in the brain. They are well-known as the "cheese reaction" due to the reaction of tyrosine from cheese. Deprenyl (Eldepryl, whatever) on the other hand is a MAO-B inhibitor which works in the brain and not elsewhere e.g. cardiovascular. Although the selectivity may not be absolute, that is why therapists can get away with using it to treat PD. See Duvoisin's book for a more lucid discussion. b) Regarding Eldepryl as possible mortality culprit, a subjective clue may be that it metabolizes to, among other things, the powerful stimulant amphetamine. I don't recall the reference, just read it somewhere. I myself had recent occasion for a blood pressure check, and noticed it had risen from its usual low value, 120/80, to about 130/70. Resting pulse rate also rose from about 55/min to 60/min or more, on dosage of 10mg/day. This is not medical opinion, merely a layman's guess, but just maybe in people who already are hypertensive (common in the elderly) Eldepryl somewhat raises the level of risk. c) The BMJ article did include a little table comparing mortality of those getting Eldepryl with those on levodopa alone, listing among others "cerebrovascular disease", "other cardiovascular disease", and "Parkinson's disease". But remember, the researchers had to compile their data from death certificates made by hundreds of local practitioners, who may or may not have been consistent in their diagnoses. And there is no mention of other possible distinctions that may have influenced the survey. Cheers, Joe J. R. Bruman (818) 789-3694 3527 Cody Road Sherman Oaks CA 91403