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Hi, Janet - You wrote: >my understanding in re pergolide/permax and bromocriptine/parlodel >is that they are the 'old guard' of the dopamine agonists >and will be shortly [this year?] outshadowed by the 'new' ones >pramipexole/mirapex, tolcapone/tasmar, and ?? a third ?? >because these new ones have much fewer side effects >and can be very much more effective in making good use of >any natural dopamine still hanging about in your brain >as well as the synthetic dopamine [aka levodopa aka sinemet] >that you take in tablet form. I, too, understood that Mirapex is supposed to have fewer side effects than the older drugs, Permax and Pergolide. I know there was a recent post on tolcapone and entacapone (the "third one you mentioned), but some of it whizzed right by my brain (that dratted Teflon coating again). I understood that Tolcapone and Entacapone are catechol-O-methyltransferase inhibitors, not dopamine agonists. Our very kind and helpful Dr. Ed Miyawaki at KU Med even drew out the chemical structure on the paper sheet of the examining table for me. Bu-u-ut, I'm hoping Dr. Ed didn't hear that whizzing sound as the info zipped right by me, since I really appreciated his taking the time to explain, and even more, appreciated his assumption that I might be bright enough to understand. So we won't tell Dr. Ed how confused I still am. I wonder if Jerry or someone could run that explanation by us again. The actual question I have is, how does a COMT inhibitor work in the brain compared to how a dopamine agonist works? Can you un-confuse me, Jerry, or someone? Thanks - Margie [log in to unmask]