The following is some information I copied into a file months ago. I don=
=92t
recall the source, but I believe this will help with everything but
Neurotonin.
Keith Chancey 45/15 months
Memphis, TN
The mainstay of therapy for PD is levodopa combined with carbidopa (Sineme=
t);
levodopa is converted into dopamine within the brain, while carbidopa prev=
ents
the peripheral breakdown of levodopa, thus effectively extending the durat=
ion
of drug action. Unfortunately, levodopa almost always loses its efficacy o=
ver
time (primarily because of disease progression) and administration is
associated with significant side effects, including response fluctuations
("on-off" phenomenon), involuntary movements, peak-dose chorea, severe end=
-of-
dose symptoms, and psychosis and hallucinations. The timed-release prepara=
tion
of levodopa (Sinemet CR) helps smooth the response, although poor absorpti=
on
of the first dose in the morning is not uncommon. Using the regular (short=
-
acting) Sinemet in the morning followed by Sinemet CR later in the day may
circumvent this problem.
Also known as deprenyl, selegiline has become a commonly used drug for
Parkinson's disease. Recent studies supported by the NINDS have shown that=
the
drug delays the need for levodopa therapy by up to a year or more. When
selegiline is given with levodopa, it appears to enhance and prolong the
response to levodopa and thus may reduce wearing-off fluctuations. Selegil=
ine
inhibits the activity of the enzyme monoamine oxidase B (MAO-B), the enzym=
e
that metabolizes dopamine in the brain, delaying the breakdown of naturall=
y
occurring dopamine and of dopamine formed from levodopa. Dopamine then
accumulates in the surviving nerve cells. Selegiline is an easy drug to ta=
ke,
although side effects may include nausea, orthostatic hypotension, or inso=
mnia
(when taken late in the day). Also, toxic reactions have occurred in some
patients who took selegiline with fluoxetine (an antidepressant) and
meperidine (used as a sedative and an analgesic).
An antiviral drug, amantadine, helps reduce symptoms of Parkinson's diseas=
e.
It is often used alone in the early stages of the disease or with an
anticholinergic drug or levodopa. After several months amantadine's
effectiveness wears off in a third to a half of the patients taking it,
although effectiveness may return after a brief withdrawal from the drug.
Amantadine has several side effects, including mottled skin, edema, confus=
ion,
blurred vision, and depression.
