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Brian, We agree. L-dopa is still number one. It produces the best effect and is most physiological in its action. Being the best however does not mean it should be the first choice for a newly diagnosed PWP. The new meds offer alternatives which complement the use of l-dopa. I don't trust drug companies and their claims either but the FDA reviews and limits what can be claimed to those things that have been proven and reviewed by unbiased experts. They tend to be conservative in fact and often lag behind the literature in the approved use of a particular drug- that's why we in the states pull out our hair waiting for new drugs to be approved. L-DOPA is clearly number one but must be used judiciously. Charlie Brian Collins wrote: > > On Mon 03 Nov, janet paterson wrote: > > > i wonder if the problem here is > > simply the wording in the books and pamphlets you mention > > > > maybe the description > > 'effective therapeutic life of levodopa' > > really should mean the > > 'honeymoon period' > > where tweaking and adjusting are not critical to > > preventing the 'on and off' phenomenon > > > > viz this description extracted from > > dr. kurth's press release on tolcapone: > > > > words in [] inserted by myself for clarity > You make my point nicely, Janet: Yu have had to add words in [ ] to > achieve clarity. As I wrote earlier Press releases for a new drug are hardly > the place where you wuld go to read an objective assessment of levodopa. > > Basically, all I am trying to do is put levodopa in its rightful place, > which, with all its admitted drawbacks, is still number 1. None of the > alternatives can match the range of effectiveness of levodopa, although > combinations of the old and the new seem to me to be even better. > > Regards, > -- > Brian Collins <[log in to unmask]> -- CHARLES T. MEYER, M.D. Middleton, WI [log in to unmask]