Brian:
On 10/24/97 I posted this note to the Parkinsn list, but I
have not seen it. Did you receive this message?
>>>Hello Brian:
>>> Brian Collins <[log in to unmask]> 10/23/97
07:43pm >>> wrote:
>>>OK, I give in. I promise not to write against selegiline
ever again (Well, not this week anyway). I had hoped to have
a friendly debate about Selegiline: Dennis had volunteered to
referee, and he seemed to be fairly impartial (- At least, he
seemed to have an equal number of chips on each shoulder)
But it all got too personal<<<
Hey Brian, I'll play! I believe the subject is "Why take
Eldepryl (Selegiline)?"
Any special rules? Dennis Greene need not absent
himself from the multilogue . . . I'm certain you'll conduct
yourself like the Peer you are. Okay, here goes:
Eldepryl is considered to be a selective MAO-B inhibitor
prescribed by some neurologists to prolong the effectiveness
of levodopa and reduce motor fluctuations and by other
neurologists in an additional attempt to slow the
degeneration of brain cells. I have not read anywhere that it
is touted as a "cure" for PD. But, neither is levodopa.
Dr. Duvoisin, M.D., in his book "Parkinson's Disease,"
2nd ed. states that adding Eldepryl to the meds is the
equivalent of increasing levodopa by about 20%.
Several recent studies (some of which were posted on
this list by Janet Paterson) have concluded that therapy with
Selegiline offers beneficial, long-term effects on the
progression of PD.
However, researchers have not been able to isolate the
mechanism that is at work. It can be neuroprotective,
symptomatic or even restorative. Most neurologists believe
that they can only perceive a symptomatic effect, with little
evidence to support the theory that it is neuroprotective.
Notwithstanding, Eldepryl has an important symptomatic
(improvement in motor fluctuations) and levodopa sparing role
in the treatment of PD.
The effects of Eldepryl upon the parts of a human nerve
cell that are susceptible to premature death are being
studied. Dr. Gerald Cohen, at the Mount Sinai Medical
Center in NYC, is studying the connection between the mao
enzyme and damage to a cell's mitrochondia (energy plant)
and PD. He is trying to determine if desmethylselegiline ( a
result of the breakdown of selegeline) has a neuroprotective
effect on the nerve cell.
So, what's the rumpus? When I first sought treatment
for PD (7 years ago this Christmas Eve, oops! wrong story)
my neurologist prescribed Inderal ( a beta blocker) which
reduced my tremor considerably for 12 months. Then as PD
progressed and I lost the symptomatic effect of the Inderal,
he prescribed Eldepryl. Again, the tremors were reduced
and my gait improved for about 12 months when I began
Sinemet. Its been Sinemet and Eldepryl for the past 5 years
and I have not experienced an increase in my PD symptoms.
My time's up - your turn.
Stephan 53/7
