 |
 |
In reply to Ron Reiner's questions - these same questions plague me too - I have two answers: the first is a scientific study, published in 1986 in the Annals of Neurology, Vol 19, April, 1986 pp. 365-372: Title: LONG-TERM FOLLOW UP OF EARLY DOPA TREATMENT IN PD by Charles Markham, MD & Shirley Diamond, an epidemiologist. The abstract says that it does not make any difference in the ultimate state of the patient if you start L-Dopa early or late: "... the results showed that the mean disability score of the three groups (Grp 1 started L-Dopa 1-3 years after onset, Grp 2 4-6 years after onset, and Grp.3 7-9 yrs after onset) ..did not differ significantly when duration of the disease was matched, even thought the Dopa therapy among the groups varied from 1 to 12 years... these data support the conclusion that the worsening over time is the result of progression of PD and not a result of the duration of Dopa treatment. Early treatment improves the beginning years of the disease and has no adverse affect on later years." The study also indicates that the mortality rates are higher after 12 years of L-Dopa for those who delayed Dopa treatment until later in their disease. The second answer is my natural gut-feel: If I am generous to my brain with artificial L-dopa, it will get lazy and the little dopamine producing capacity left is more likely to atrophy. Initially I postponed taking Sinemet for 3 years despite the uging of my very competent neurologists. After eading the above paper, I struck a compromise between gut feel and scientific evidence: I take as little Sinemet as I can to make me function well. Hope this is helpful. Ilan Levi (52, PD 5 yrs [log in to unmask])