Hello howardb,
Did you know that Selegiline is now available in the US under the
brand names of ?Carbex? and ?Eldepryl? ? Have you discussed this
recently with your doctor? If you were on it before, it?s quite
possible your doctor can prescribe it now, in accordance with your
medical history.
Selegiline, a monoamine oxidase inhibitor, seems to decrease
Parkinson?s patients? ?Off time? by potentiating (increasing) the
effects of levodopa. The concurrent dose of levodopa must be
decreased, however, to avoid the reverse effect.
When used alone, selegiline can cause nausea, insomnia, dizzinedd,
headache, and cardiac arythmias (irregular heartbeats). When used
together with levodopa are fatigue, nausea, insomnia, dizziness and
constipation. Serious side effects have been reported when taking
selegiline with meperidine (Demerol).
http://www.holistic-online.com/Remedies/Parkinson/pd_selegiline.htm
http://www.selegiline.com/safety.html
According to Medline, these drugs should never be taken while taking selegiline:
·Antidepressants, tricyclic (amitriptyline [Elavil], amoxapine,
[Asendin], clomipramine [ Anafranil], desipramine [Norpramin], doxepin
[Sinequan], imipramine [ Tofranil], nortriptyline [Pamelor],
protriptyline [Vivactil], trimipramine [ Surmontil])
·Fluoxetine (e.g., Prozac) or
·Fluvoxamine (e.g., Luvox) or
·Meperidine (e.g., Demerol) or
·Nefazodone (e.g., Serzone) or
·Paroxetine (e.g., Paxil) or
·Sertraline (e.g., Zoloft) or
·Venlafaxine (e.g., Effexor)?Using these medicines together may
increase the chance of serious side effects.
Additionally, patients with stomach ulcers may not want to take this
medication. While taking this medication, check your blood pressure
often, watch for unusual physical movements, agitation and chest
pains.
If your daily dose of selegiline was 10mg or less, you will have no
dietary restrictions. If the dose is higher, then you will need to
follow some dietary guidelines such as avoiding smoked, aged, and
pickled foods such as bologna, smoked sausages, pepperoni, and most
cheeses. You can see a complete list, as well as symptoms to watch
for, on the site linked below:
http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202519.html
Some newer dopamine drugs showing promise are Ropinirole and Pramipexole:
Ropinirole
?A five-year comparison study with L-dope reported that ropinirole was
more than twice as effective in controlling dyskinesias. In fact,
patients taking ropinirole alone experienced no progression of
dyskinesia. There were no significant differences in the number and
severity of complications. Overall, however, the effectiveness of the
two drugs was comparable in terms of daily living, probably because
L-dopa still controlled motor symptoms better.?
Pramipexole
?A 2001 analysis of controlled studies reported that pramipexole
reduced off time, improved impaired movements and disability compared
to placebo. Patients had a higher incidence of dyskinesia and
hallucinations. (These studies did not compare it to L-dopa.)
A large, US-Canadian 2000 study comparing L-dopa to pramipexole found
that 72% of patients who took pramipexole as their first therapy
remained free of dyskinesia for two years, compared to 49% of those
taking levodopa. Pramipexole therapy, however, resulted in fewer
benefits in symptoms overall than L-dopa, and a greater incidence of
sleepiness, fluid build-up, and hallucinations.?
http://www.ucdmc.ucdavis.edu/ucdhs/health/a-z/51Parkinsons/doc51otherdrugs.html
Stalevo
Stalevo was approved by the US FDA about a year ago, and seems to be
an effective treatment for some patients.
?The difference between STALEVO and other levodopa therapies is that
STALEVO also contains entacapone. Entacapone helps levodopa last
longer by blocking a substance in the body called a COMT enzyme. This
enzyme breaks down levodopa before it reaches the brain. When less
levodopa is broken down, more is available to the brain. Increased
availability of levodopa may lead to smoother and steadier levels of
dopamine in the brain, which may provide better symptom control for
longer periods each day. This may lead to improvement in daily
activities.?
http://my.webmd.com/content/pages/16/98655.htm?z=4238_0000_2751_sn_03
Exercise and Diet
Exercising will not stop Parkinson?s, but is can improve gait,
balance, muscle tone, and overall well being. A well balanced diet is
very important to maintain. Three nutrients you should pay particular
attention to are fiber, calcium/vitamin D, and protein. Parkinson?s
patients may be prone to constipation, so you want to eat a lot of
fiber (roughage). Extra calcium will help prevent brittle and weak
bones! You will want to *decrease* your protein, and try to eat the
largest portion of it in the evening.
http://www.medicinenet.com/Parkinsons_Disease/page6.htm
?PD patients may benefit from an exercise regimen that includes
aerobic activity (done at a training rate of 60 to 70% maximal heart
rate), strengthening exercises, and stretching. Ideally, the exercise
regimen will be followed at least three times per week and will
improve aerobic capacity, and muscle strength and flexibility.
Patients may want to consult a physical therapist or PD exercise group
for specific exercise suggestions?
http://www.wemove.org/par/par_ide.html
You may be interested in reading my previous answers relating to
Parkinson?s Disease:
http://answers.google.com/answers/threadview?id=357122
http://answers.google.com/answers/threadview?id=77302
Please discuss your treatment options with your doctor, as s/he is the
best source of information for your particular case.
I hope this is the information you are seeking! If not, please request
an Answer Clarification, before rating. This will enable me to assist
you further, if possible. I wish you the best!
(By mentioning your time is *up*, I wonder if you are using a public
computer. If you *are* using a public computer in a library, please
ask the librarian for more time so you can read through all the
material I have presented. Shhhhhh...I worked in our public library,
and I know we can give extra time for certain special interests. You
can even be assisted in printing out at least part of this information
as well.)
Sincerely,
crabcakes
Search Terms
Recent developments parkinson?s
Drug therapies parkinson?s 2004
daily living parkinson's |
Clarification of Answer by
crabcakes-ga
on
27 Jun 2004 11:54 PDT
Hi howardb,
Thank you for clarifying your question for me. I certainly
misunderstood, as it appeared to me you flew to London because you
could not obtain selegiline in the US. Please also forgive the
confusion over using a public computer. Hundreds of thousands of
patrons utilize library computers each day, and that is what I thought
when I read ?my time is up?!
In your question, you asked ?Are there any other drugs or things to
do to slow the advancement and give me a better quality of life.? I
will repost the drugs I listed In my original answer, here, for ease
of reading, after which I will address your numbness :
Ropinirole
?A five-year comparison study with L-dope reported that ropinirole was
more than twice as effective in controlling dyskinesias. In fact,
patients taking ropinirole alone experienced no progression of
dyskinesia. There were no significant differences in the number and
severity of complications. Overall, however, the effectiveness of the
two drugs was comparable in terms of daily living, probably because
L-dopa still controlled motor symptoms better.?
Pramipexole
?A 2001 analysis of controlled studies reported that pramipexole
reduced off time, improved impaired movements and disability compared
to placebo. Patients had a higher incidence of dyskinesia and
hallucinations. (These studies did not compare it to L-dopa.)
A large, US-Canadian 2000 study comparing L-dopa to pramipexole found
that 72% of patients who took pramipexole as their first therapy
remained free of dyskinesia for two years, compared to 49% of those
taking levodopa. Pramipexole therapy, however, resulted in fewer
benefits in symptoms overall than L-dopa, and a greater incidence of
sleepiness, fluid build-up, and hallucinations.?
http://www.ucdmc.ucdavis.edu/ucdhs/health/a-z/51Parkinsons/doc51otherdrugs.html
Stalevo
Stalevo was approved by the US FDA about a year ago, and seems to be
an effective treatment for some patients.
?The difference between STALEVO and other levodopa therapies is that
STALEVO also contains entacapone. Entacapone helps levodopa last
longer by blocking a substance in the body called a COMT enzyme. This
enzyme breaks down levodopa before it reaches the brain. When less
levodopa is broken down, more is available to the brain. Increased
availability of levodopa may lead to smoother and steadier levels of
dopamine in the brain, which may provide better symptom control for
longer periods each day. This may lead to improvement in daily
activities.?
http://my.webmd.com/content/pages/16/98655.htm?z=4238_0000_2751_sn_03
According to this Orion Pharma, who is currently performing
Parkinson?s research, drugs that contain entacapone are the most
promising for patients whose current therapy is timing out too soon.
Staleveo, mentioned above, does contain entacapone.
http://www.hightechfinland.com/2002/healthcare-lifesciences/sivu.php?id=orionpharma&listby=
You can read about new drugs being tested now, on this page from The
National Parkinson Foundation, Inc.
http://www.parkinson.org/whatdrugs.htm
Tingling, Numbness/Neuropathy/ Paresthesias:
Numbness and tingling of extremities is not uncommon in Parkinson?s
disease, but you should discuss your concerns with your doctor. Since
you have already ruled diabetes out, s/he should seek the root of the
problem, and treat accordingly. There are drugs that can control
neuropathy, but they may not be compatible with the medications you
are currently taking.
Numbness and tingling indicate there is pressure or damage to the nerve.
Causes of tingling and numbness can include (This list is NOT all inclusive)
·local injury to the nerves under the skin
·lack of blood supply to the area
·pressure on the nerves, caused by a herniated disk, tumors, abscesses
or arthritic bones
·toxic action on nerves (lead, alcohol, tobacco)
·diabetes and other chemical abnormalities
·vitamin B-12 deficiency
·hypothyroidism
·carpal tunnel syndrome
·drugs such as chemotherapeutic agents, chloroquine, D-penicillamine,
isoniazid, nitrofurantoin, parenteral gold therapy and phenytoin
·long-term radiation
·transient ischemic attack (TIA)
·stroke
·multiple sclerosis (a less common cause of numbness)
http://www.healthcentral.com/mhc/top/003206.cfm
?Chronic inflammatory polyneuropathy affects approximately 6 out of
10,000 people. It is a common type of damage to nerves not in the
brain or spinal cord?
Symptoms:
·weakness, usually in the arms and hands or legs and feet
·facial weakness
·difficulty walking
·difficulty using the arms and hands or legs and feet
·sensation changes (usually of the arms and hands or legs and feet)
opain, burning, tingling, or other abnormal sensations
onumbness or decreased sensation
http://www.healthcentral.com/mhc/top/000777.cfm
http://www.parkinson.org/polyneuropathy.htm
I found some interesting information about diet soda?s and Parkinson?s
while researching your answer.
From this site, a discussion of aspartame, the sweetener found in diet
sodas, Parkinson?s Disease, and Michael J. Fox:
?The enzyme phenylalanine hydroxylase converts phenylalanine to
tyrosine. Tyrosine is first transformed into dihydroxyphenylalanine
(levodopa), and then to dopamine.
* The two dopamine receptor subtypes (D1 and D2) exert synergistic
effects on the firing rates of basal ganglia neurons (Walter l987).
* The importance of dopaminergic pathways in severe tremor is further
suggested by the effectiveness of levodopa in treating both
parkinsonism and "restless legs" (von Scheele l986).
·There is a reduction of brain dopamine in the presence of high
concentrations of phenylalanine (Congressional Record-Senate l985b, p.
S 10846).?
http://www.rense.com/general21/parkinsonFox.htm
Aspartame is often blamed for numbness and tingling. In this report,
15% of those studied (82 people) reported symptoms of parasthesia.
http://www.health-report.co.uk/aspartame-toxic-effects.htm
http://www.dorway.com/drlydon.txt
I hope this additional information is useful to you!
Regards,
crabcakes
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