Re: Levodopa toxicity a myth?

[Ervin McCarthy <ervinmccarthy@xxxxxxxx>]

Roxanna, did you ever pursue the home page of Dr. Malkmus?

I have been using his carrot juice regimen for the past six months and find
it very beneficial.  How is the Sinemet working?  I have backed off of it
temporarily. Best Wishes

----- Original Message -----
From: Roxanna Nakamura <roxyn@xxxxxxxxxxxxx>
To: <PARKINSN@xxxxxxxxxxxxxxxxxxxx>
Sent: Monday, March 20, 2000 8:44 PM
Subject: Re: Levodopa toxicity a myth?


> Hi Ervin,
>      Just to clarify, I think that the authors of the
> articles do *not* believe that levodopa makes Parkinson's
> worse, but they disagree on whether levodopa likely causes
> problems like motor fluctuations. I think they use the term
> "toxic" in several different ways, and that can be a bit
> confusing. But for me, a key phrase was Weiner's "Currently
> there is no evidence that levodopa use irreversibly damages,
> destroys, or harms dopaminergic cells in patients with
> Parkinson disease."
>      These articles don't challenge the recommendation to
> "start low, go slow" with levodopa though, to avoid side
> effects and in case research does prove that the drug
> eventually stops working for people and/or causes
> irreversible problems. As Shulman's article explains,
> dopamine agonists and COMT inhibitors can be used to cut
> down on levodopa use -- even without definitive research
> results -- on the theory that it probably will help and
> probably won't hurt. Have you talked with your doctor about
> these other drugs? I don't think my father's neurologist has
> ever suggested anything like that, and I wonder why not.
>      I don't take anything for my tremor, but my father is
> taking Sinemet and he is worried about what it might be
> doing to him. He tries to skip one of his three 25/100
> Sinemet doses when he's having a low-tremor day, despite his
> neurologist's disapproval. (Is this OK? I don't know.) He
> read somewhere that Sinemet destroys brain cells, so these
> articles should at least relieve that worry.
>      Hope this is helpful. I am interested in
> non-pharmaceutical measures too. Who is Dr. Malkmus? Best
> wishes.
> Roxanna
>
> On Sat, 18 Mar 2000 Ervin McCarthy <ervinmccarthy@xxxxxxxx>
> wrote:
>
> >Roxanna, I read your references to toxicity of levodopa and
>
> >more confused than ever. As a new participant to levodopa
> it  is
> >noteworthy that they suggest the possibility of earlier
> progression of the >disease when using levodopa.  Are you
> using it and what strength?  >Always looking to learn. I
> have been pursuing natural therapies like Dr.
> >Whitaker and Dr. Malkmus.  Best wishes.
> ----- Original Message -----
> From: Roxanna Nakamura <roxynEARTHLINK.NET@>
> To: <PARKINSN@xxxxxxxxxxxxxxxxxxxx>
> Sent: Thursday, March 16, 2000 1:25 PM
> Subject: Levodopa toxicity a myth?
>
> > I just came across these interesting new articles in the
> > AMA's Archives of Neurology:
> >
> > "Is Levodopa toxic?" by William J. Weiner, M.D.
> >
>
> >
> > "Levodopa toxicity in Parkinson Disease: Reality or Myth?"
> by Lisa M. Shulman, M.D.
> >
>
> >
> > "Levodopa toxicity" by Vladimir Hachinski, M.D.
> >
>
> >
> > Despite the titles, these articles are encouraging.
> > Apparently, research does *not* support the theory that
> > levodopa hastens disease progression or cell death. On the
>
> > contrary, levodopa extends life and decreases disability.
> > The real "toxicity" concern, the authors say, is
> whether/how
> > levodopa really is related to motor fluctuations and
> > dyskinesia.