Tuesday, 31 January 2012

Prevention and treatment of Parkinson's Disease: ECT, nicotine, caffeine

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Some reflections on Parkinson's disease, and the related Lewy body dementia; which are the second most common cause of degenerative brain disease (after Alzheimer's) - increasingly common in the developed world, probably due to the 'ageing population'.

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The current medical treatment of Parkinson's disease seems to be extremely poor.

It is based around L-dopa, which seems to be a miracle cure at first, for a short time, but then almost always produces severe side effects and/or loses its effect.

It looks as if L-dopa is just too powerful a drug (almost a pure neurotransmitter), and the brain responds by 'fighting' the drug - i.e. the brain's homeostatic mechanisms are seriously destabilised by L-dopa, and the patient veers between hyperstimulation and 'freezing'.

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On the other hand, electroconvulsive therapy/ ECT/ electroshock has been shown to be effective in some patients with Parkinson's disease in numerous trials - yet this fact is virtually unknown.

ECT is a much safer treatment than L-dopa. And even if it wasn't, Parkinson's is an extremely severe and debilitating illness - indeed people have had experimental brain surgery and transplant procedures (albeit with little success) for Parkinson's.

So there seem no valid reason not to try a course of ECT in Parkinson's, and maintenance ECT if it produces significant benefit.

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There is very strong evidence (mostly from studies of tobacco smoking) that nicotine is preventive of Parkinson's disease, and sometimes helps treat it. This is rational, given that nicotine indirectly increases dopamine activity.

Nicotine can be safely given with skin patches with minimal side effects (for most people).

Why is nicotine not used in prevention/ early-treatment of Parkinson's?

Why is it not even tried?

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There is also evidence that caffeine (coffee) is preventive of Parkinson's disease, and there is also a rationale for this because caffeine is a mild psychostimulant with dopamine boosting actions.

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So, in Parkinson's disease we have a very serious and common disease with hopeless conventional treatment - we have in ECT a powerful treatment which almost certainly helps some people, even with severe PD - and we have in nicotine and caffeine two non-prescription treatments which almost certainly prevent the illness, and improve the early stage of the illness.

Why are they virtually unknown, why don't people try them?

Obviously, if they are tried and they don't work, or make things worse; then stop.

But why not try, especially when current treatment is so bad?

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With ECT there is a very obvious prejudice against the treatment - a fear and horror which is ignorantly and dishonestly stimulated.

At root, probably this is because ECT is opposed by Big Pharma who want people to take ineffective/ harmful medication instead of an effective physical treatment. Drugs are marketed to the tune of 1000 dollars per head of population in the USA. IN a competitive world, with a rate of turnover and change, simply by not being marketed, agents drop out of use.

With nicotine and caffeine there is the problem (folk belief, media manipulation) that these drugs are supposed to be 'bad for you' according to the mainstream mass media ideas of 'health promotion'. There is therefore an underlying discomfort in recommending for health reasons a lifestyle or treatment associated with smoking and drinking strong coffee.

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Whatever the reasons, the complete uninterest in effective treatment for people with very severe, common, debilitating, distressing, progressive disease is altogether typical of modern society.

Contrary to what might be imagined, modernity cares little for functionality, is all-but indifferent to effectiveness.

So it really is possible for effective, safe and available treatments of a common and severe illness to languish, unused; despite that anyone with Google Scholar could find out about them in five minutes...

This is the actuality of the information revolution: knowledge hidden in plain sight.

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