At 17:17 4-10-98 -0400, you wrote:
>I saw this on 'CNN - Your Health' today and thought it was so
>interesting, I did a search so I could send it on to you...
Listmembers,
I did read the CNN rapport about this. Amantadine is in fact an anti-virus
med.,
but that is, in the view of neuroresearchers, not the reason why it has
effect in treating Parkinson. It is also a glutamate antagonist. Glutamate
and dopamine are both neurotransmitters and neuromodulators, that are
mutually inhibiting. So a shortage of dopamine does make glutamates to
active. Relative low dopamine levels can cause depression, because dopamine
has a role in the reward center in our brain. So an effectivity of
amantdine against depression could be expected and does not prove that a
virus has some role in causing PD
Someone might relate this glutamate to other mails on the list today who
mention feeling well after eating some sweets. The text that I did read
said very explicitly that this glutamate is a rather complex molecule,
can't pass the blood-brain barrier, and has to be produced in the CNS. If I
read this kind of stuff, I know enough to feel I understand something of
it, but I don't know enough neurophysiology to read it really critically.
So at last everyone deciddes for himself what is most convincing.
I am interested in the glutamates because much recent litterature says
anti-glutamates are expected to be highly effective against end of dose
dykinesia, and against craving of drug-- or alcohol addicts. I have on an
intuitive level thought this were related phenomena.In Germany, university
of Tuebingen, an anti glutamate has been developed and partly tried.
Memantine is a derivative of the decades old anti-influenza drug
amantadine. Memantine is used in Germany to treat Parkinson's disease,
dementia in the elderly, and to speed the recovery of comatose patients.
Memantine may also be useful for PWAs with HIV encephalopathy (which can
mean anything including memory loss,confusion, difficulty speaking,
walking, and/or concentrating).
Memantine in PWAs
While some PWAs have been using memantine, and the AIDS Clinical
Trial Group is currently planning to study it at present there is no data
from any clinical study in PWAs. We'll keep you posted on upcoming trials.
Since there is no proven treatment for HIV-related neurologic problems, the
PWA Health has decided to import memantine for any PWA with a doctor's
prescription.
The Theory Behind Memantine While the root cause of neurologic
problems in PWAs is different from what causes Parkinson's or dementia in
Elderly, people with these problems all lose neurons, the key brain or
nerve cell, in much the same way.(PWAs with encephalopathy can lose up to
20-50% of their neurons.) How does this happen? Much of what we know comes
from experience in Parkinson's disease. As the theory goes, too much of
certain amino acids in the brain send signals to neurons that make them
self-destruct. Memantine keeps to a minimum the destructive signals that
neurons receive. These amino acids may be elevated in some PWA's too.
What's worse, test tube and animal studies show that the HIV protein gp120
can also send neurons self-destruct signals. But until we know to what
extent HIV related neurologic disorders are caused by these signals, we
can't predict how helpful memantine will be in PWAs. If the theory is
correct, another drug being studied in PWAs for neurologic problems,
nimodipine, may increase the effect of memantine. With a prescription you
can get nimodipine from a pharmacy, but it is very expensive, and since it
isn't approved for this purpose, your insurance may not want to
pay for it.
Want more info? We have references available. Just ask us.
Dosing
We don't know the best dose for PWAs. In other groups, doses range from
5-60 mg a day, depending on the condition that it is being used for. 10-30
mg a day seems to be the standard maintenance dose in patients with
Parkinson's disease. Since there isn't much information on the use of
memantine in PWAs, it may make sense to start at a low dose, such as 5 mg a
day (see below).
Does someone of the German listmembers/readers knows more about this from
own or a friends experience. If so, I am highly interested to know. Fur
mich ist Deutch lesen eben so leicht wie Englisch. Wenn Sie mich personlich
schreiben konnen Sie das auf Deutsch machen. Ich mochte dann eben auf
Deutsch antworten.
Ida 54/14, Holland
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Vriendelijke Groeten / Kind regards,
Ida Kamphuis mailto: [log in to unmask]
