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Hi Barbara, My neuro is a London based specialist who has written a paper on treatment (Niall Quinn, British Medical Journal 4 March 1995 "Drug treatment of Parkinson's disease"). He uses a criteria of greater than 70 years old, start immediately on levodopa and below 50 keep off levodopa by using other drugs if possible. In between he says is a matter for judgement (if you are in imminent danger of losing your job, or for other personal reasons etc. take levodopa ), but probably use controlled release levodopa before adding an agonist. In my case (light symptoms) he offered me Pergolide (Permax) or Bromocriptin (Parlodel). I chose Pergolide (his preference). He said that for some people Pergolide could be effective for 5-6 years, others much shorter. My target dose was 6 x 250 micrograms per day (but have not been successful in achieving this yet, I'm not comfortable with the drug). Before Pergolide I was taking Selegiline (Eldepryl). His question was did it help? My reply was it did not seem to make much difference. His advice "there is perhaps (and I stress the perhaps) some statistical evidence emerging of an unexpected slight increase in unexplained mortality for people taking it for more than five years". The protective nature of the Selegiline is not substantiated by the current research (now 9 months since I had this conversation with him) and the "protection" is more likely a direct relief of symptoms. (I guess that means it does not stop the critical cells dying). This advice on Selegiline supersedes the advice given in his publication. It took me 30 days to stop taking the drug and it is 60-90? days before the body is completely clear. The paper also addresses other drugs and issues and appears to be a comprehensive summary. Others in the news group can probably offer a much better critic ( I would like to understand the Selegiline situation more as so many people seem to take it - am I missing out or ahead of the crowd?) I am not sure if it helps. This is just like - well you can take the Selegiline or stop it - and - well you can have Pergolide or Permax - your choice, up to you (why don't I write the prescription myself). In reality (and hindsight), I have no problem with being given this choice - there is no hard and fast rule for these decisions, the statistics are obviously well in the grey zone. Hope this is not too long. Best regards Barbara Blake-Krebs wrote: > Hi Jim: > > I find your experience really puzzling because the order in which you > started > your medications is the reverse of what is usual. Being a non-medical > person > myself, I can only tell you that as a lay person with PD it suggests > to me > that you had too much dopamine evidentally naturally occurring in your > > system! Otherwise, I can't phathom why the Parlodel alleviated > symptoms when > you were NOT taking sinemet. Because I take Parlodel too, I once > asked my PD > specialist whether Parlodel could ever be taken alone for PD and as I > recall > he said "no." > > You mention that you have seen some neuros. Have any of these been > Movement > Disorder Specialists or PD Specialists? I would urge you to consult > with > one. I imagine that people from the Seattle area on this list can > give you > some recommendations. Good luck! > > Barbara Blake-Krebs (56, 13) [log in to unmask] > > on Sat,31 May 1997 15:19:53 -0400 Jim Traweek > <[log in to unmask]> > wrote in part: > > <<A few months ago, having lost nearly all ability to write, I started > > taking Parlodel (bromocryptine) for the tremor I was experiencing. > The > Parlodel seemed to help as my tremor lessened. About a month ago, I > went to another neurologist who felt I had PD and again prescribed > sinemet. My reaction was dramatic. Within ten days, my medication > was > eliminating at least ninety percent of the symptoms that I had been > experiencing. > > I am still a little dazed with thankfulness for a substantial part of > my > life being restored. I am also wondering why sinemet had no effect on > me > earlier and how much to attribute its present effectiveness to > parlodel > working as an agonist. I've only been reading this list for about ten > > days, but during that time, there has been little mention of parlodel. > > Do many PWP take parlodel, and what are their feelings about it? > > Jim Traweek, 52 Seattle, W>>