On Mon 27 Oct, jim and emily jackson wrote:
> I vote to continue the seligiline debate--we personally are at a critical
> juncture re choices for treatment, and appreciate the input.
>
> Brian: what about taking seligiline at relatively low doses vs. high doses
> vs. not at all? Jim has upped his seligiline from one to two 5mg tabs
> daily, says he thinks it is helping him symptomatically (tremors and
> fatigue). No problems with dreams or insomnia. I have seen and heard so
> much about the limited-term(5-year) efficacy of sinemet that I tend to
> agree with our neuro about waiting to start it, especially as he has a lot
> of trouble adjusting to new meds. Jim really isn't too badly off, this
> early in the disease. So naturally the purported neuroprotective aspects
> of seligiline are VERY interesting to us. The info in your most recent
> post surely has made the decision difficult, though:
Hello Emily, I just had to reply to the point which you mentioned re: limited
term (5 yr)efficacy of Sinemet. I am convinced that this depressing view
of Sinemet is total rubbish. I am now in my 17th year of taking levodopa
(Sinemet and Madopar), and with the aid of Permax, I am still fairly active
at 57 (diagnosed 18 yrs; first symptoms 24yrs ago). You must have been
listening to some of the older neuros - the ones who think you would be OK
if you would just get a grip on yourself!
The real situation (which I have personally checked with 5 neurologists)
is that the point at which you start levodopa (Sinemet) has NO influence on
what happens after 5, 10 or whatever years. They seem to think of Sinemet as
some sort of non-rechargeable flashlight battery: use it now, and you will
have none left when it gets really dark. Absolute rubbish. Yes, it does
get more and more difficult to achieve a good balance of tablet-based
levodopa, but this is due to the fact that you are steadily losing dopamine
producing cells. And when I say 'you' I mean Everyone, Selegiline takers as
well continue to lose cells.
Do not forget that Selegeline only works if the hypothesis as to what
causes PD is correct. There are other theories, some just as likely as
others, BUT nobody knows for sure. Last week whe I asked, I was told that
current thinking is moving back to genetic causes (Not heredity necessarily)
but some damage to some genes perhaps.
It annoys me to see early PWPs being starved of levodopa in their early years, when early introduction could do so much good
Regards,
--
Brian Collins <[log in to unmask]>
