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I have slightly surprised myself to find that my instinctive first reaction to the approval of Tolcapone in America was relatively low key. Having thought it through, I think I can now begin to see what my problems are. The situation is not one-sided; there is good and bad potential in Polcapone which I will try to descibe. 1. Tolcapone is, as J. R. Bruman informed us, a COMT inhibitor. COMT is one of the enzymes found in the brain which, interacts with Dopamine, thus destroying its ability to act as a neuro-transmitter. The idea is that by controlling the level of COMT, we can create a less hostile environment for the Dopamine, coming either from the levodopa or the substantia Nigra. 2. The advantage of Tolcapone is that it can be added to the existing schedule of drugs, without needing to compensate by backing-off on one or more of the current schedule. 3. just as the Anticholinergic drugs (Artane, Cogentin, Parsidol etc) act by reducing the amount of acetylcholine in the brain, so Tolcapone reduces the amount of COMT in the brain. Thus the Dopamine in the brain lasts longer, giving a net improvememnt in the quantity of Dopamine in the brain. 4. What bothers me about Tolcapone is that it is acting to reduce the normal amount of COMT in the brain, and I can't help wondering if that level of COMT is necessary for other (Unrecognised reasons -- Brian Collins <[log in to unmask]>