What is Parkinson’s disease?
Parkinson's disease is a degenerative disorder
of the central nervous system. The motor
symptoms of Parkinson's disease result from
the death of dopamine-generating cells in
the substantia nigra, a region of the midbrain;
the cause of this cell death is unknown.
MOVEMENT-RELATED (Motor) - shaking, rigidity, slowness of
movement and difficulty with walking and gait. Later,
AND BEHAVIOURAL PROBLEMS
Dementia commonly occurring in the advanced stages of the disease.
SYMPTOMS - sensory, sleep and emotional problems.
PD is more common in the elderly, with most cases occurring after
the age of 50.
The accumulation of a protein called alphasynuclein into inclusions called Lewy bodies in
neurons, and from insufficient formation and
activity of dopamine produced in
certain neurons within parts of the midbrain.
Carbidopa-levodopa (Parcopa). Levodopa, the most effective Parkinson's disease medication, is a natural chemical that
passes into your brain and is converted to dopamine. Levodopa is combined with carbidopa, which protects levodopa
from premature conversion to dopamine outside your brain, which prevents nausea. In Europe, levodopa is combined
with a similar substance, benserazide (Madopar). Side effects include nausea or a drop in blood pressure when standing
(may result in faintness).
After years, as your disease progresses, the benefit from levodopa may become less stable, with a tendency to wax and
wane ("wearing off"). Also, you may experience involuntary movements (dyskinesia) after taking higher doses of
levodopa. Your doctor may lessen your dose or adjust the times of your doses to control these effects.
Dopamine agonists. Unlike levodopa, dopamine agonists don't change into dopamine. Instead, they mimic dopamine
effects in your brain. They aren't as effective in treating your symptoms as levodopa. However, they last longer and may
be used with levodopa to smooth the sometimes off and on effect of levodopa.
Dopamine agonists include pramipexole (Mirapex) and ropinirole (Requip). A short-acting injectable dopamine agonist,
apomorphine (Apokyn), is used for quick relief.
The side effects of dopamine agonists are similar to carbidopa-levodopa, but also include hallucinations, swelling,
sleepiness or compulsive behaviors such as hypersexuality, gambling and eating. If you're taking these medications and
you start behaving in a way that's out of character for you, talk to your doctor.
Anticholinergics. These medications were used for many years to help control the
tremor associated with Parkinson's disease. Several anticholinergic medications are
available, including benztropine (Cogentin) and trihexyphenidyl. However, their modest
benefits are often offset
Side effects: Impaired memory, confusion, hallucinations, constipation, dry mouth and
Amantadine. Doctors may prescribe amantadine alone to provide short-term relief of
symptoms of mild, early-stage Parkinson's disease. It also may be added to carbidopalevodopa therapy for people in the later stages of Parkinson's disease, to help control
involuntary movements (dyskinesia) induced by carbidopa-levodopa.
Side effects: a purple mottling of the skin, ankle swelling or hallucinations.
MAO B inhibitors. These medications include selegiline (Eldepryl, Zelapar) and rasagiline (Azilect).
They help prevent the breakdown of brain dopamine by inhibiting the brain enzyme monoamine
oxidase B (MAO B). This enzyme metabolizes brain dopamine. These medications can't be used in
combination with most antidepressants or certain narcotics, due to potentially serious reactions.
Check with your doctor before taking any additional medications with a MAO B inhibitor.
Side effects: rarely include nausea or headaches. When added to carbidopa-levodopa, these
medications can increase the risk of hallucinations.
Catechol O-methyltransferase (COMT) inhibitors. Entacapone (Comtan) is the primary medication
from this class. This medication mildly prolongs the effect of levodopa therapy by blocking an
enzyme that breaks down levodopa. The side effects are primarily those due to an enhanced levodopa
effect, including an increased risk of involuntary movements (dyskinesias). Tolcapone (Tasmar) is
another COMT inhibitor that is rarely prescribed due to a
Side effect: Risk of serious liver damage and liver failure.
Parkinson's disease can affect anyone, regardless of social or economic class or geographic
Each year, approximately 50,000 Americans are diagnosed with Parkinson's disease.
Statistics indicate that this condition seems to affect men at a slightly higher rate than
it appears to affect whites more than African Americans or Asians.
However, it is likely that everyone has a similar probability of developing Parkinson's
Teva Pharmaceutical Industries Ltd. (TEVA), an Israeli based company which was founded in 1901,
develops and manufactures a variety of pharmaceuticals. It received approval from the U.S. Food and
Drug Administration for AZILECT® (rasagiline tablets) as a treatment for Parkinson's disease. It has a
P/E of 54 and a PEG of 1.1. The stock has been paying dividends quarterly and yields 1%.
Cell Genesys, Inc. (CEGE) is an investor in Ceregene, which developed CERE-120, its lead program
for Parkinson's disease. Earnings for CEGE are negative and the P/S is an extremely high 225.
Novartis AG (NVS), a very large Swiss pharmaceutical company, has developed Comtan®
(entacapone), a medication for the treatment of Parkinson's Disease. Its P/E is 19 and the PEG is 1.5. It
has a yield of 1.6%.
Acadia Pharmaceuticals Inc. (ACAD), based in San Diego, is working on ACP-103 in patients with
Parkinson's disease suffering from treatment-induced psychosis. It has negative earnings, and a P/S
Sanofi-Aventis (SNY) is the third largest pharmaceutical company in the world. It is working on
SR57667B for treatment of symptoms. Its PE is 23 and its PEG is 2.3. It has a of yield is 2.1%.
SkyePharma plc (SKYE) developed the once-daily formulation of Requip® utilizing SkyePharma's
Geomatrix™ technology. Requip® is used for Parkinson's treatment. It has no earnings, and its P/S is
Valeant Pharmaceuticals International (VRX) markets Zelapar® [selegiline HCl] Orally
Disintegrating Tablets, a once-daily adjunct therapy for Parkinson’s disease patients being treated
with levodopa/carbidopa. It has a forward P/E of 16.6 and a PEG of .8. It has a yield of 1.7%.
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Adolf Hitler - (April 20, 1889 - April 30, 1945)
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