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HI P. JONES -
EARLY, MONTHERAPY FOR PWP, WHO ARE UNDER 60
YRS OLD, IN WHICH TREMOR IS THE PRIMARY
SYMPTOM, USUALLY CALLS FOR "ARTANE"
(TRIHEXYPHENIDYL).  IT IS THE MOST COMMON
ANTICHOLINERGIC DRUG - WHICH WORKS BY
BLOCKING THE ACTION OF ACETYLCHOLINE IN THE
BRAIN.  SIDE EFFECTS ARE DRY MOUTH, BLURRED
VISION, NAUSEA, CONSTIPATION AND RAPID HEART
BEAT.  THESE LIMIT THE EFFECTIVE USE OF ARTANE.
SELEGELINE (ELDEPRYL) IS MORE USEFUL AS A
NEUROPROTECTOR AND THEREFORE, IS THOUGHT TO
DELAY THE NEED FOR LEVODOPA THERAPY.  ON THE
HORIZON ARE THE COMT  (CATECHOL-O-METHYL
TRANSFERASE) INHIBITORS [ENTACAPONE,
TOLCAPONE]  NOT CURRENTLY AVAILABLE.  THEY
BLOCK THE ENZYME (COMT) THAT BREAKS DOWN
DOPAMINE IN THE BRAIN.

STEPHAN S.