31st August 2010 - New review


Stalevo is a drug for Parkinson's Disease that is a combination of L-dopa, carbidopa and entacapone. That is the same as Sinemet plus entacapone. For more information go to Stalevo. The therapeutic constituent is L-dopa. Entacapone is a COMT inhibitor, which is able to slow down the breakdown of L-dopa. Stalevo is intended for the treatment of people with Parkinson's Disease who experience signs and symptoms of end-of-dose "wearing off" [1]. A series of studies showed that Stalevo and corresponding dosages of L-dopa / carbidopa plus entacapone had the same effect [2]. A clinical advantage of Stalevo is that patients can take one pill rather than two (or more) separate tablets [2].

Over 70% of the patients that added entacapone to their Sinemet (or the equivalent), or that switched to Stalevo, which includes all three, felt that they were clinically improved. Over 80% of them experienced a reduction in fluctuations [3]. About 8% of people that changed to Stalevo discontinued treatment, mostly because of adverse events. There was also a tendency for Stalevo to initiate or worsen dyskinesia [4]. Stalevo resulted in an improvement in symptoms [4] [5] [8] [11]. There was also an improvement in "on" time [9] [10]. Patients found Stalevo more simple to dose, more convenient to use, easier to handle, easier to remember and easier to swallow [7]. A majority of patients preferred Stalevo to L-dopa and carbidopa when in a sustained release form, and improved their symptoms when they changed over to it [6].

The U.S. Food and Drug Administration (FDA) is evaluating clinical trial data that may suggest that patients taking Stalevo may be at an increased risk for developing prostate cancer. Patients taking Stalevo were compared to those taking carbidopa and levodopa. The number of people taking Stalevo with prostate cancer was small, but it was still four times what would otherwise be expected. The FDA consequently suggested that "Patients should not stop taking their medication unless directed to do so by their healthcare professional" [12].  They are also evaluating clinical trial data that suggest patients taking Stalevo may be at an increased risk for cardiovascular events (heart attack, stroke, and cardiovascular death) [13]. In order to refer to this article on its own click here.


21st August 2010 - New review


Prolonged exposure to lead can double the likelihood of developing Parkinsonís Disease [Complete abstract]. Common means of exposure are : lead contaminated soil, ingestion of lead dust or chips from deteriorating lead-based paints. Air pollution from the processing of lead, food grown in contaminated soil, drinking water from plumbing and fixtures that are either made of lead or have trace amounts of lead in them. Lead can be found in cosmetics in some countries, some herbal remedies, and even in toys. For more information go to Lead Poisoning.

Means of toxicity : Due to the similarity of their structures, lead can inadvertently replace iron in enzyme reactions, but lead does not properly function as a cofactor. This might cause a reduction in L-dopa because iron is an essential cofactor for L-dopa formation.

Most lead poisoning symptoms are thought to occur by interfering with the enzyme Delta-aminolevulinic acid dehydratase (ALAD), which is required for the formation of hemoglobin, as is ferrochelatase, which is also interfered with lead. Hemoglobin transports oxygen, which is required for the formation of L-dopa. So lead may also cause Parkinson's Disease symptoms by interfering with the availability of oxygen to the brain. However, the precise means by which it causes Parkinson's Disease has still not been proven.

Symptoms : Serious and chronic exposure to lead can more than double the likelihood of developing Parkinson's Disease, making it 2.27 times more likely. Milder exposure to lead did not increase the likelihood of Parkinson's Disease [Complete abstract]. In order to refer to this article on its own click here.


17th August 2010 - New book


Carl E.Clarke

Publisher's description : Parkinson's Disease in Practice provides practical, up-to-date summaries on how to manage Parkinson's disease in everyday practice. The title reflects the current developments surrounding Parkinson's disease and the fields of pharmacology and surgery making this an indispensable guide full of tips and useful advice. This title reviews the entire spectrum of Parkinson's disease, and includes topics as its epidemiology and aetiology, pathophysiology, and potential investigations. This book will be of great value to general practitioners, hospital doctors, Parkinson's Disease Nurse Specialists and paramedical therapists working in this area, as well as students of medicine, pharmacology and pharmacy Click here for more details. In order to refer to this article on its own click here. For more books concerning Parkinson's Disease go to Parkinson's Disease Books.


14th August 2010 - New review


Duodopa is a combination of L-dopa and carbidopa in the form of a gel. It is administered throughout the day using a portable pump directly into the small intestine through a surgically placed tube. For the Duodopa fact sheet.

The method ensures a flow of L-dopa that can be adjusted according to the patient's individual needs [1]. It enables more consistent plasma concentrations of L-dopa [3]. Significant improvements were found with its use [2] [5] [6]. The side effects are similar to those observed with oral administration of L-dopa and carbidopa [3] [4]. Dislocation of the intestinal tube to the stomach was the most common technical problem [2] [3] [4], occurring in nearly 70% of the patients during the first year [4]. Whether L-dopa consumption was reduced or increased with infusion as compared to oral therapy differed according to the study [2] [4] [6]. In order to refer to this article on its own click here.


12th August 2010 - History


Nicholas Culpeper (1616-1654) was an English botanist, herbalist, physician and astrologer. He published books, The English Physitian (1652) and the Complete Herbal (1653). The Complete Herbal contains both pharmaceutical and herbal knowledge. Among the recommendations he suggests sage for "sinews, troubled with palsy and cramp". For centuries prior to this, Sage had also been recommended for tremor in the hands. Amongst other plant remedies Culpepper suggested for palsy and trembling were bilberries, briony (called "English mandrake"), and mistletoe. In the 1696 edition of his Pharmacopoeia Londinensis, a variety of substances were claimed to be useful in the treatment of "palsies", the "dead palsy", and "tremblings". These included the "oil of winged ants" and preparations including earthworms ! For more concerning the history of Parkinson's go to the History of Parkinson's Disease.


9th August 2010 - New review


An ancient civilisation in India practiced their medical doctrine called Ayurveda. They described the symptoms of Parkinson's Disease, which they called Kampavata as far back as 5000 B.C.. To treat Kampavata, they used Mucuna Pruriens, which is certainly the oldest known method of treating the symptoms of Parkinson's Disease.

Mucuna pruriens is a tropical legume whose seeds are a natural source of high quantities of L-dopa. Immature seeds contain maximum L-dopa content [1]. Mucuna Pruriens is a milder source of L-dopa than the quantities of L-dopa in pharmaceutical forms. Its mildness lessens the problem of excessive dosage that often occurs with the use of L-dopa in pharmaceutical form. Mucuna Pruriens is also more adjustable in its dosages. It can be used for Parkinson's Disease as a form of L-dopa [2].

In optimal dosages, Mucuna Pruriens acts more quickly than L-dopa, and its effects last longer. There are no major differences between them regarding possible side effects [3]. Mucuna Pruriens also possesses anti-oxidant qualities, which help to protect against cell damage, and also metal chelating activity, which helps to protect against excessive quantities of metals [4]. There is no evidence that it contains the equivalent of carbidopa, which is a substance in Sinemet that reduces L-dopa breakdown before it is reaches the brain. In order to refer to this article on its own click here.


3rd August 2010 - New research


Movement Disorders [2010] Jul 28 [Epub ahead of print] (Lolekha P, Phanthumchinda K, Bhidayasiri R.) Complete abstract

Blows to the head are sometimes claimed to have been a cause of Parkinson's Disease. Boxing, with its frequent blows to the head is often believed to be a cause of Parkinsonism because of chronic repetitive head injury, with Muhammad Ali frequently, but very possibly wrongly, cited as an example. Even more extreme and frequent blows to the head occur in Kick Boxing, in which participants receive not only punches, but also kicks to the head. Kick Boxing is at its most extreme in Thailand, where it originated, as the sport of Muay Thai. As the blows are more powerful and the contests more frequent, Muay Thai tests the impact of blows to the head even more than boxing. In order to assess the effect of blows to the head, this study determined the prevalence of Parkinson's Disease in retired Muay Thai boxers.

Out of over 700 that responded, only 5 of them had Parkinson's Disease, which is not even 1% of boxers. So boxing, even in the extreme form found in Thailand, did not make Parkinson's Disease likely, nullifying the claim that boxing and blows to the head commonly cause Parkinson's Disease. Those Muay Thai boxers that had a large number of professional contests were found to be a bit more prone to developing Parkinson's Disease. So frequent blows to the head appear to cause an inclination to Parkinson's Disease rather than actually cause it. In order to refer to this article on its own click here.


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