 |
 |
On Thu 26 Mar, Ervin McCarthy wrote: > To all list members, > > I am curious to know if there are any members who have chosen to do without > drugs in early onset of PD. If there are it would be interesting to know > the results. I see so much controversy on the list about the various > drugs. Is it possible that anyone has been successful by not starting the > drugs in the early stages. It may sound like a silly question but I would > like to see some discussion of the matter. Thank you. > > Ervin > > > Ervin, I think the answers that you get to your question will be related to how long ago the person was diagnosed. In the early years it may be possible to struggle along with no drugs, but eventually Old Jim will get you. If you were maybe harbouring a faint wish that if you do nothing to provoke it further it may go away again, you have only to read about the awful suffering that PWPs had to accept before the invention of L-Dopa in the 1950s. Having got that out of the way, the next question is an old favourite: Having started on drugs, are there some drugs which can safely be taken early in the progress of the disease, and some which should be avoided. In the use early category we have Selegiline - Supporters of this drug are a little quieter these days, but it may do some good in protecting the brain from further degeneration. It seems that as longer-term experience of this drug becomes available in properly-conducted tests, the less certain is the evidence for its neuro-protective capabilities. I see it in the maybe/maybe not box: I would just point out that I tried it for a while, and dropped it because of its side-effects. Amantadine is mentioned in early treatment: It seems capable of a certain amount of relief, but I have yet to see an explanation of 'Why?' or How? It also seems to become ineffective after a few years. ReQuip, one of the newer Dopamine agonists was claimed by its makers to be OK to use in the early days of PD, as well as a therapy for older PWPS. I strongly suspect that most all of the Doapmine agonists will also respond postively - It's just that the ReQuip people were the first to think of it. But remember, all the agonists are capable of very disturbing side-effects which must be carefully evaluated while in use. And so we come to the big one: Levadopa. There are two stronhly- opposed groups here. Suffice it to say that I firmly believe that early, use of Sinemet/Madopar is OK, and the bonus that results (For example in allowing the PWP to continue work) is enormous. My experience is: Diagnosed 1979: Prescribed Artane : Useless. Almost had to give up work. Moved on to Sinemet 1980. Effectively allowed me to function 'normally' Continued work until retirement in 1994 age 54 Present day: still using Levodopa (Madopar) plus Permax, and typically get through a day with about 2 hours of Off time, and the rest On, (with little sign of dyskinesias due to careful dosing. Well Ervin, that should generate enough debate, so I will step back into the shadows and see what results. Regards, -- Brian Collins <[log in to unmask]>