L Dopa

[PKE]

I have been reading articles about the use of L Dopa to relieve some of the spasticity caused by Parkinsons. My main MS related issue is the spasticity in my legs. Bad, getting worse. None of the "drugs' I have been prescribed help in any way. Has anyone tried L Dopa for spasticity relief?

[Scott1]

Hi,

L-Dopa might help. You say "Drugs" but I don't know what that means.

Have you tried Baclofen? It has helped my spasticity quite markedly. It's a potassium channel blocker and I tried to explain how it works on April 30th here- http://www.thisisms.com/forum/regimens- ... 9-210.html . The only thing I would say is muscle relaxation is ATP dependent so you need to also boost the efficient recycling of ATP which I covered on Dec 8th 2014 in the same post.

Regards

[PKE]

Baclofen upsets my stomach. I have 3 drugs prescribed. Oxybutryn, 1 day, Tizanaden 6 divided day, Desmopresen as needed, usually just emergencys.

I am not sure what would happen if I quit taking all of them, but as near as I can tell, they are doing nothing.

By the way, I have primary progressive. No attacks, just a steady downhill slog.

[Scott1]

Hi,

The medications tell me a fair bit about what troubles you (or what the doctor thinks troubles you).
I'm not a doctor so take what I say with a grain of salt. The oxybutynin is an anticholinergic so it's trying to change the way a neurotransmitter influences muscle action in the smooth muscle associated with the bladder. It's an antispasmodic so it can worsen incontinence if the problem is related to overflow because it won't help muscles contract.
Desmopressin works by limiting the amount of water that is eliminated in the urine. So, on one hand your stopping the bladder from spasming and on the other your trying to reabsorb water. A bit like putting bandaids on a dam wall from my perspective. Be careful if you back off these as too fast a withdrawal may cause unwanted spasms.

Tizanaden is pretty heavy duty. Be careful about your choice of antibiotics and avoid alcohol. It looks like you take rather a lot of this. Consider a liver test because of that. It's supposed to be a maximum of three doses in 36 hours. Be careful if you come off it as that can cause spasms. (remember your heart is just a muscle). There is a long list of medications that contraindicate with this so be very sure about what else your taking.
It's a muscle relaxant. Sometimes you need muscle tone. (Eg the bladder)
Again, I'm not a doctor but I would raise the roof wanting to know why I have this combination.
Muscles are supposed to contract and relax. To contract they need a signal to influence calcium to activate an action. To relax they need ATP to send an alternate message. What your on look like palliatives to me. They won't work for long because they are not really working with the natural process. They are intervening to deal with an imbalance.
At the risk of being boring you could try reading my own thoughts here -http://www.thisisms.com/forum/regimens- ... 9-165.html from Dec 8th 2014 onwards. You need to have a look at how muscles both contract and relax.

I agree with you and doubt these medications are helping but be very careful if you stop taking them and think about the downside of suddenly stopping. You need another strategy and it might be worth looking at elements of diet and supplements that could be introduced before you stop any of the current medications.
Perhaps another doctor might be a better plan.
Regards

[lyndacarol]

I'm not a doctor so take what I say with a grain of salt. The oxybutynin is an anticholinergic so it's trying to change the way a neurotransmitter influences muscle action in the smooth muscle associated with the bladder. It's an antispasmodic so it can worsen incontinence if the problem is related to overflow because it won't help muscles contract.
Desmopressin works by limiting the amount of water that is eliminated in the urine. So, on one hand your stopping the bladder from spasming and on the other your trying to reabsorb water. A bit like putting bandaids on a dam wall from my perspective. Be careful if you back off these as too fast a withdrawal may cause unwanted spasms.

Tizanaden is pretty heavy duty. Be careful about your choice of antibiotics and avoid alcohol. It looks like you take rather a lot of this. Consider a liver test because of that. It's supposed to be a maximum of three doses in 36 hours. Be careful if you come off it as that can cause spasms. (remember your heart is just a muscle). There is a long list of medications that contraindicate with this so be very sure about what else your taking.
It's a muscle relaxant. Sometimes you need muscle tone. (Eg the bladder)
Again, I'm not a doctor but I would raise the roof wanting to know why I have this combination.
Muscles are supposed to contract and relax. To contract they need a signal to influence calcium to activate an action. To relax they need ATP to send an alternate message. What your on look like palliatives to me. They won't work for long because they are not really working with the natural process. They are intervening to deal with an imbalance.
At the risk of being boring you could try reading my own thoughts here -http://www.thisisms.com/forum/regimens- ... 9-165.html from Dec 8th 2014 onwards. You need to have a look at how muscles both contract and relax.

I agree with you and doubt these medications are helping but be very careful if you stop taking them and think about the downside of suddenly stopping. You need another strategy and it might be worth looking at elements of diet and supplements that could be introduced before you stop any of the current medications.
Perhaps another doctor might be a better plan.

From an earlier post by NHE: http://www.peoplespharmacy.com/2015/01/ ... -dementia/

These medicines are known as anticholinergics (http://www.peoplespharmacy.com/2011/01/ ... as-we-age/ ) because they interfere with the ability of a crucial brain chemical called acetylcholine (Ach) to attach to nerve cells. ACh is essential for muscle contraction. Without adequate amounts of this neurotransmitter you could not breathe, blink your eyes or tie your shoelaces. Body movement can only happen when ACh triggers a muscular contraction.
Acetylcholine is also critical for proper brain function. Without ACh doing its job transmitting messages between brain cells, you would become forgetful and confused.

About anticholinergics specifically: No one should ever stop such medications without medical consultation.

[DrGeoff]

"L-dopa to relieve spasticity in Parkinsons?" Sounds a touch out of date to me!
L-dopa was the treatment of choice for Parkinsons back in the 1960's, as a dopamine precursor.
These days it is known as levodopa, and is normally only found in a compound with carbidopa, benserazid, or entacone. Find these in names like:
Sinemet, Madopar, Ropinerole.

It is a neuro-transmitter; one of several that act to facilitate the transmission of nerve impulses across a synapse. Particularly, it facilitates motor control. In crude terms, too much dopamine and you are heading toward psychosis. Not enough and you are heading toward Parkinsons.

Yes, it does (in one or other of the compounds) smooth out some of the Parkinsons symptoms (essential tremor, restless legs) and can help with spasticity.
As for MS, there was an article in "Medical Hypotheses" about 10 years ago, but I don't think anything came of it.

[PKE]

This is the article that caught my eye.

Just got me wondering (hoping and praying) there might be a connection.

http://www.foxnews.com/health/2015/04/2 ... -symptoms/

[DrGeoff]

I could almost believe it - until I read the whole piece.
My comments about "L-dopa" still stand.
From personal experience, there is about an 80-85% commonality of symptoms between Parkinsons and MS. However:
Parkinsons is down to a lack of Dopamine secretion in the brain, and is usually diagnosed by the effect of a small dose of one of the Dopamine based compounds.
MS is caused by - well the jury is still out on that one - but is diagnosed by a process of test and exclusion (like negative tests for Lyme disease, B12 deficiency, Devic's disease, and positive MRI and LP).
All that they have in common is that they are both neurological in nature.
If the story had come up in a reputable journal, then it might be truly credible - but in Fox news, copied from The Mighty?
Sorry, but do not hold your breath waiting for this to emerge as an MS treatment.

[PKE]

Ok, try this source.

I agree about the last one, FOX news has to be the least reliable "news"? network on any subject.

So, went to google and found this http://www.nytimes.com/health/guides/di ... pa%29.html

I am a whole lot less of a scientist than you, so really don't pretend to know what I am talking about. The only reason I ask the question is we have been seeing the same neurologist, who is a specialist in MS and Parkinsons, for about 15 years. He is the one that prescribed the current drug cocktail. I keep hoping we might stumble over something that might relieve some of the symptoms because he is stuck in his "accepted practices" box. I know cure is out of the question, but getting the body to relax the muscle spasticity seems possible to me. So, I keep searching.

Thank you for your interest and advice.

[DrGeoff]

I think that the NYTimes article is a very fair statement of the whole Dopamine thing. Certainly it is a lot less technical than Wikipedia.
In the end, it comes down to just which symptom bothers you most (or which symptom your consultant thinks should bother you most).
That is the one you will walk out with a Rx for.

[Scott1]

Hi,

The message in this thread is don't play with your medications without proper medical help. Do it the wrong way and you're juggling hand grenades. Get another doctor involved or have a very good discussion with your current one. Don't do it yourself.
When you said Baclofen gave you a funny tummy, what else were you taking?

Regards

[PKE]

No intention of going it alone, or juggling hand grenades. Just seeking some alternatives. The stuff I am taking offer me no relief nor seem to slow the progression. Just frustrated.

Our medical science is sort of locked in a box of accepted practices, I am wondering if there is anything outside the box.

Interesting discussion of L Dopa, also interesting thread on sunlight.



Who knows?

[Scott1]

Well, I might be outside the box. You can read this -

http://www.thisisms.com/forum/regimens- ... 24019.html

plus a number of other good posts are spread across the sites

Regards