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Hi Yesim, Maryse, Joao, Michel, Sonia, and Gil, I definitely continue to do much better on Tolcapone (Tasmar) with Sinemet plus Selegeline Hydrochloride, than with no Tolcapone. I hope anyone else comparing Tolcapone to Entacapone, or those considering Entacapone (Comtan and Comtess). may find the description of Entacapone helpful. The message is re-titled . Ivan :-) ^^^^^^ WARM GREETINGS FROM ^^^^^^^^^^^^ :-) Ivan Suzman 50/39/36 [log in to unmask] :-) Portland, Maine land of lighthouses 33 deg. F :-) ******************************************************************** Hi Yesim, I am a young-onset PWP, in my 14th year since identifiable PD-related symptoms appeared, in 1986. These many years of battling PD have allowed me an opportunity to accumulate an understanding of how Entacapone, and its chemical relative, Tolcapone, are supposed to work for people with PD. Please remember I am not a physician. I am only trying to explain what I think is most relevant, to answer your questions. I would NOT replace Madopar with Entacapone. Entacapone is designed to work in conjunction WITH Madopar or Sinemet. Entacapone is an inhibitor of an enzyme, catechol O-methyl transferase (COMT). COMT normally blocks dopamine. When COMT is inhibited by adding Entacapone, more dopamine is thus able to reach the brain. Dopamine is derived from levodopa, or L-dopa (dihydroxyphenylalanine). This L-dopa is contained in Sinemet, and in Madopar. L-dopa, swallowed in tablet form, must reach the tissues of the brain. In the brain, the L-dopa is converted to the dopamine missing in PD patients. Your father's Madopar ought to be more helpful if Entacapone is ADDED to his Madopar. The Entacapone may allow him to reduce the amount of Madopar he takes, and enhance better, smoother walking and movemen in general. I would suggest that you explain this to your dad, and work with his physician to see if the addition of Entacapone will block enough COMT to improve his condition, while also reducing symptoms caused by dopamine deficiency. I hope this all makes sense, and helps. Sincerely, Ivan Suzmna (50/39/36) Portland, Maine USA :-) On Sat, 20 Nov 1999 19:20:00 -0800 Yesim Erman <[log in to unmask]> writes: >I am from Turkey and my father, who is 68, has had PD for eight years >and he has been using Madopar and Dopergine since then. We have come >to >a stage that we are having problems with his medication. A little bit >much of it causes some side effects- dyscinesia, and less of it >causes >stiffness and slowness and this goes on and off all day long with >jerky >movements. He says that he is not satisfied with it anymore. His doc. >suggested that he change Madopar into Etacapone (CUT)