Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0030567 (Parkinson's disease)
 63,064 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Twenty-two patients with Parkinsonism were treated with levoamphetamine and 12 of these with dextroamphetamine. Levoamphetamine resulted in a significant improvement in disability from Parkinsonism, although the reduction in total disability, tremor, akinesia, and rigidity scores was slight (ca 20 percent). Dextroamphetamine in lower dosage also reduced disability by some 17 percent. The most disabled patients, including those also on levodopa, showed the greatest response to amphetamines. Previously, amphetamines have been reported to be a selective treatment for the oculogyric crises of post-encephalitic Parkinsonism. Amphetamines are thought to cause the release of catecholamines from central neurones. Their action in Parkinson's disease may be limited because of pre-existing striatal dopamine deficiency. Side-effects of amphetamines, anorexia, and CNS stimulation are different from those caused by levodopa in patients with Parkinson's disease.
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PMID:Amphetamines in the treatment of Parkinson's disease. 109

A double-blind study comparing the effects of carbidopa and levodopa combined in a single tablet with levodopa alone was undertaken in 50 patients with Parkinson's disease. After 6 months, there was a statistically significant improvement over baseline in total score, rigidity, and tremor only in the patients randomized to carbidopa/levodopa. In addition, 40 percent of the patients treated with carbidopa/levodopa showed obvious clinical improvement (a greater than 50 percent reduction in their total score) over treatment with levodopa alone. However, after 2 years, only 20 percent continued to show this improvement. Nausea, vomiting, and anorexia developed in 56 percent of patients on levodopa but in only 27 percent of patients on carbidopa/levodopa. However, abnormal involuntary movements, observed in 48 percent of patients on levodopa, were present in 77 percent of patients on carbidopa/levodopa. Despite the increase in abnormal involuntary movements, carbidopa/levodopa is more effective than levodopa.
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PMID:Comparison of dopa decarboxylase inhibitor (carbidopa) combined with levodopa and levodopa alone in Parkinson's disease. 110 Oct 99

The behaviour of some urinary metabolites of tryptophan/nicotinic acid pathway was studied in 7 patients with Parkinson's disease during a 24-day period of levodopa treatment. Corresponding to the appearance of side-effects (agitation, anorexia, dysphagia, glossitis, abdominal pains) in 5 patients there was an increase in urinary Ky, AA, AAG, o-AHA, and 3-HK, while 3-HAA excretion fell. Since no other drugs were given, it was presumed that this effect was due to levodopa administration.
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PMID:Tryptophan/nicotinic acid pathway during levodopa treatment of Parkinsonism. 124 93

Fifty Thai patients with Parkinson's disease of all staging were allocated for 10 mg/day L-deprenyl therapy as the monotherapy (6 patients) and adjunctive therapy for at least two months. The assessment of this open study included the activities of daily living using Schwab/England Scale, Hoehn and Yahr staging and Unified Parkinson Disease Rating Scale (UPDRS) by comparison of the initial and after two month of treatment scores. There was improvement of both Schwab/England Scale and UPDRS in Hoehn and Yahr stage I, II and III patients. In stage IV and V patients there was no benefit of L-deprenyl therapy of both clinical and statistical analyses. Adverse effects of L-deprenyl were not serious. There were dry mouth (20%), anorexia (10%), nausea and vomiting (8%), insomnia (6%), lightheadedness (4%) constipation (4%), abdominal pain (2%), generalised ache (2%). We conclude that L-deprenyl therapy is effective, safe, but costly. It is more effective in early Parkinsonism. The effectiveness of L-deprenyl is less in more advanced states of Parkinson's disease. Thus, selection of the appropriate Parkinsonian patient for L-deprenyl therapy is vital.
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PMID:L-deprenyl therapy in Thai patients with Parkinson's disease: before and after, clinical trial of 50 patients. 212 33

1-methyl-4-phenyl-1,2,5,6-tetrahydropyridine (MPTP) has been shown to produce a parkinsonian syndrome in humans and other primates. Recent studies have demonstrated that in humans the hypothalamus has the highest binding density for (3H) MPTP, which corresponds to monoamine oxidase type B (MAO-B). There is evidence that the conversion of MPTP to the toxic compound MPP+ takes place in the hypothalamus; subsequently, MPP+ is transported to the striatal system, where destruction of nigrostriatal dopamine neurons occurs. Thus, the hypothalamus appears to be a primary target organ of MPTP toxicity. This assumption is supported by the observation that monkeys exposed to MPTP exhibit extensive pathological lesions in the hypothalamus which are manifested clinically by the development of life-threatening anorexia requiring forced feeding to overcome. We discuss the clinical implications of MPTP-induced hypothalamic damage to the pathophysiology of MPTP-induced parkinsonism and to Parkinson disease. It is suggested that consideration of hypothalamic involvement in MPTP-induced parkinsonism may provide a broader understanding of the pathophysiology of parkinsonism and may, in addition, account for the preliminary observations that MAO-B inhibitors retard the progression of Parkinson disease and possibly prolong life expectancy.
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PMID:The hypothalamus in MPTP-induced parkinsonism. 224 19

Previous investigators have suggested that numerous symptoms used to diagnose depression, such as sleep or appetite disturbance, are non-specific in medically ill patients, and alternative diagnostic criteria should be developed. In the study this hypothesis was tested in Parkinson's disease (PD) by comparing patients with PD who reported a depressive mood with patients having PD but without a depressive mood. Depressed patients showed a significantly higher frequency of both autonomic and affective symptoms of depression. Depressed patients with PD reported a significantly higher frequency of worrying, brooding, loss of interest, hopelessness, suicidal tendencies, social withdrawal, self-depreciation, ideas of reference, anxiety symptoms, loss of appetite, initial and middle insomnia, and loss of libido when compared with non-depressed patients. No significant between-group differences, however, were observed in the frequency of anergia, motor retardation, and early morning awakening.
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PMID:Specificity of affective and autonomic symptoms of depression in Parkinson's disease. 226 68

Several pharmacologic agents provide antihistamine effects by acting at the H1 histamine receptor site. The classic agents are relatively nonselective, resulting in a wide range of effects, both therapeutic and undesirable. The newer agents preferentially block peripheral H1 receptor sites and, consequently, have fewer side effects, including sedation. Antihistamines are useful in the treatment of allergic conditions, Parkinson's disease, insomnia and some forms of nausea, and provide symptomatic relief of cough and other conditions associated with respiratory tract infections. Certain agents may play a role in the treatment of asthma and anorexia. Selection of a specific agent should be based on cost and the minimization of side effects. The classic antihistamines provide an inexpensive and highly effective means of treating histamine-mediated symptoms. The bothersome central nervous system side effects can be alleviated by taking the drugs at bedtime; their prolonged tissue half-life allows dosing once or twice a day for 24-hour clinical relief. The newer, more expensive nonsedating antihistamines are acceptable alternatives for patients who are incapable of tolerating the effects of classic agents.
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PMID:Antihistamines: the old and the new. 762 32

We report one case of parkinsonism induced by cisapride and one case of Parkinson's disease whose symptoms were worsened by cisapride. Case 1. A 75-year-old female who had suffered from constipation and loss of appetite, was treated with cisapride for her gastro-intestinal symptoms. One year later, she developed progressive parkinsonian gait, cogwheel rigidity She showed parkinsonian gait, cogwheel rigidity and slowness in motion. Two months after cisapride was discontinued, her parkinsonism and depression disappeared. Case 2. A 66-year-old female with Parkinson's disease was given cisapride for constipation. Two months after starting cisapride, her akinesia and rigidity deteriorated gradually, and she became bed-ridden with dysphagia and dyspnea. After cisapride was discontinued, her parkinsonian symptoms improved gradually, and she became ambulant three months later. Cisapride is a benzamide derivative with a prokinetic action. Experimental studies have revealed that it has indirect cholinomimetic effects and potentially stimulates the gastrointestinal motor activity without blocking dopamine receptors or activating muscarinic cholinergic receptors. However, the present cases showed that cisapride could be a dopamine receptor blocker, and either induce or worsen parkinsonism. Therefore, cisapride should be avoided or very carefully used in parkinsonian patients and old people.
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PMID:[Parkinsonism induced or worsened by cisapride]. 772 93

External application of picoTesla range magnetic fields (MF) has been reported recently to be efficacious in the treatment of patients with Parkinson's disease (PD) including those who manifest levodopa-related dyskinesias. In the present communication, we present four additional Parkinsonian patients who showed, within a brief period of time, marked improvement in motor symptoms after therapy with MF. Three of the patients had been maintained on antiParkinsonian medication during treatment with MF while the fourth patient had never received pharmacotherapy. Improvement with magnetic therapy was noted not only in the motor sphere (resting tremor, gait apraxia, postural instability), but also in nonmotor aspects of the disease including mood, sleep, pain, anorexia, autonomic, and cognitive functions attesting to the unique efficacy of external picoTesla range MF in the treatment of Parkinsonism. Poverty of facial expression (hypomimia, "masked facies"), which correlates with the degree of striatal dopaminergic deficiency, is one of the clinical hallmarks of PD reflecting the severity of hypokinesia and rigidity in the orofacial musculature. In this report, we emphasize the effects of MF on the hypomimia of PD and provide visual documentation illustrating the changes in the patients' facial expression which follow treatment with MF.
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PMID:Further observations on the unique efficacy of picoTesla range magnetic fields in Parkinson's disease. 808 4

Two patients with Parkinson's disease repeatedly increased their levodopa dosage on their own to 1500-2000 mg/day to reach and sustain a state of euphoria, regardless of the fact that dosages of 400-800 mg/day were sufficient to suppress their parkinsonian symptoms. Both were markedly unwilling to consent to recommendations of dosage reductions, and they readily accepted adverse effects such as hyperkinesias, anorexia, and hallucinations to achieve the positive mental effects. Thus, both patients fulfilled the diagnostic criteria for substance dependence.
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PMID:Levodopa dependence and abuse in Parkinson's disease. 932 93


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