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Phil Tomkins - well said--concise and accurate and helpful in helping many PWPs as they weigh the pros and cons of starting Sinemet. Nancy Shlaes deGrazia NancyS. deGrazia Phil Tompkins wrote: > Paul Ayers wrote: > > > In a discussion with my General Practice Dr. she stated that one > > could become "sensitive" (if that is the right word) to the meds. I > > came away from that conversation thinking that if I just put up with > > the tremors, stiffness, and wandering thought process for a time, > > then I could put off meds for a time until I "really" need them. > > Does this make any sense? > > Hello and welcome to the list. > > In my opinion (10th year with PD dx and still learning): > > 1. It's a good idea to see a neurologist who is a movement disorder > specialist. > > 2. It makes no sense to postpone medication if the symptoms are a > problem or even a discomfort. The opinion you run across from time > to time that PD meds (levodopa in particular) only work for five > years or so is wrong. They may work indefinitely. They may work for > 5 or 10 years with no objectionable side effects (such as > dyskinesia). And the duration without side effects is not relative > to how long you have been on the medication, but rather to > progression of the disease and to one's age. > > 3. Many patients with early PD are over-medicated. You need the > minimum dose level that gets rid of the symptoms. > > 4. Different people have different "sensitivities" to different > meds. You won't know about yourself until you try. > > 5. Starting in the early stages of PD it may be worth the gamble > to use medicines and supplements that are alleged to be > neuroprotective and therefore slow the progress of the disease. > There is research (not the latest word, perhaps) indicating that > Eldepryl and Permax may be neuroprotective (references below > for anyone interested). Antioxidant supplements such as Co-enzyme > Q10 and (alpha-)lipoic acid may be worth looking into (see e.g., > http://www.networkantioxidants.com - I don't get any kickbacks!). > > Best of luck, > > Phil Tompkins > Hoboken NJ > age 61/dx 1990 > > Gomez-Vargas M, Nishibayashi-Asanuma S, Asanuma M, Kondo Y, Iwata E, > Ogawa N. Pergolide scavenges both hydroxyl and nitric oxide free > radicals in vitro and inhibits lipid peroxidation in different > regions of the rat brain. Brain Res 1998 Apr 20;790(1-2):202-8. > PMID: 9593894. > > Mytilineou C, Radcliffe PM, Olanow CW. L-(-)-desmethylselegiline, a > metabolite of selegiline [L-(-)-deprenyl], protects mesencephalic > dopamine neurons from excitotoxicity in vitro. J Neurochem 1997 > Jan;68(1):434-6. PMID: 8978757. > > Mytilineou C, Radcliffe P, Leonardi EK, Werner P, Olanow CW. > L-deprenyl protects mesencephalic dopamine neurons from glutamate > receptor-mediated toxicity in vitro. J Neurochem 1997 > Jan;68(1):33-9. PMID: 8978707. > > Opacka-Juffry J, Wilson AW, Blunt SB. Effects of pergolide treatment > on in vivo hydroxyl free radical formation during infusion of > 6-hydroxydopamine in rat striatum. Brain Res 1998 Nov > 9;810(1-2):27-33. PMID: 9813228.