Dear Joe: Tricyclics countering the action of levodopa? How
come I didn't know this? More important, how come my neuro
didn't know this? Any refences will be appreciated.
Carole H.
--- "J. R. Bruman" <[log in to unmask]> wrote:
> I don't think so; but what do I know? I haven't had it
> myself, and I'm
> not even a medical professional, but I see reports of it
> from a few list
> members, that make me wonder. As I said before, the Merck
> Manual doesn't
> mention it, although it does impute certain ANTI-dopamine
> drugs, and it
> has plenty to say about the various forms of dyskinesia
> and their cause.
> Likewise, the long paragraphs in the PDR Sinemet
> description covering
> Warnings, Precautions, and Adverse Reactions (note the
> descending order
> of importance) contain no mention of dystonia caused by
> Sinemet, except
> when it is taken together with a tricyclic
> antidepressant, a class of
> drugs well-known to counter the action of levodopa.
>
> So how explain reports from a minority of listmembers,
> contradicting the
> overwhelming majority experience and conventional wisdom?
> I suspect the
> problem is semantic. It's hard to define exclusively the
> difference
> between dyskinesia and dystonia, and even harder to
> interpret what each
> different patient thinks he feels. I've mentioned
> elsewhere the possible
> confusion of very mild peak-dose dyskinesia with resting
> tremor, and
> since tremor, dyskinesia, and dystonia all involve the
> contraction of
> muscles, perhaps the latter two can possibly be confused
> sometimes.
>
> In any case, I've not yet heard of dystonia like that
> described by Marty
> related positively to levodopa. The question might be
> resolved if he
> follows his neuro's advice to avoid Sinemet (and other
> dopaminergic
> drugs), but IMHO, since Marty certainly has PD, that
> doesn't sound like
> a very good idea. Cheers,
> Joe
> --
> J. R. Bruman (818) 789-3694
> 3527 Cody Road
> Sherman Oaks, CA 91403-5013
>
=====
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