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Part III of my subjective summary of the symposium. If I inadvertently misrepresent anything said at the symposium please send corrections to the List. Dr. C. Warren Olanow, Professor and Chairperson of the Department of Neurology, Mount Sinai School of Medicine, N.Y., was the third speaker. His topic was "Concepts of Neuro Protection." (He did not note at the outset of his presentation that his subject focus -- Selegiline -- was currently controversial or that he was himself one of the authors of the so-called Datatop Study.) Dr. Olanow began his presentation by restating that while PD patients have been improved with the use of levodopa (Sinemet), there nonetheless comes a time (generally 5 to 10 years) when the side-effects become intolerable, new problems arise, and levodopa therapy becomes less effective; hence the need to focus in on new neuroprotective therapy. Selegiline (Deprenyl, Eldepryl) is one of the drugs trying to solve the levodopa associated problems. If scientists knew what causes PD they could easily solve the mystery of treatment, but not knowing this they have moved to the next step of studying how the cells in the substantia nigra are affected. They do know that the degeneration of cells produces highly toxic free radicals or dopamine oxidizing agents. They are researching how to block the metabolism of dopamine. Dr. Olanow went on to describe the Datatop Study of the use of vitamin E and the use of Deprenyl as a metabolism blocker. He and his colleagues in the study randomly divided some 800 patients and followed their progress. The initial phase of the research revealed that Selegiline slowed the rate of disability among PD patients and that vitamin E did not. The next phase of the study dealt with the symptoms of PD and concluded that those patients who received Selegiline had significantly less symptoms than those who were on a placebo. Because Selegiline affected the rate and the symptoms of PD, Dr. Olanow is hopeful that in the future we will be able to develop even more effective neuroprotective drugs. The recent British Medical Journal article [ much discussed here on the Parkinsn List ] on the death rate of those who used Selegiline created concern among the Datatop authors who went back and re-examined their data. Dr. Olanow and his colleagues concluded that there was no difference in the death rate between those who did and didn't use Selegiline; if anything, Selegiline patients had less mortality. They also looked at other studies conducted by others and found no evidence of increased mortality. Laboratory and clinical studies of neuroprotection encourage the use of Selegiline along with Sinemet, and that is how Dr. Olanow treats his patients. -------------------- Sid Roberts 66/dx2 [log in to unmask] Youngstown, Ohio