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21.09.2005:
   21.09.2005

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PARKINSONISM TREATMENT WITH AMINO ACID COMPOUNDS.

O.N. Gerasimova, Cand. Sc. (Med.), neuropathologist
1997

INTRODUCTION

Treatment of parkinsonism remains an urgent problem of modern neurology; substitution therapy with L-DOPA preparations allows to temporarily improve the condition of parkinsonism patients and is often accompanied by side effects (1, 2). A.P. Khokhlov suggested a new method of parkinsonism treatment based on the use of amino acid compounds (individually selected combination of amino acids) with due regard for present neurochemical disorders in extrapyramidal pathology (glutamate exchange disturbance, toxicity of calcium ions, etc.).

The objective of our study was to analyze the efficacy of course treatment of parkinsonism with amino acid compounds by A.P. Khokhlov's method.

MATERIAL AND STUDY METHODS

The study group was made up of 53 parkinsonism patients (40 patients were ill with Parkinson's disease), age range 40-80 years, the average age being 59 years. 35 patients had a shaking-rigid form of parkinsonism, 11 were found to have an akinetic-rigid form and the remaining 7 patients had a shaking form thereof. 35 patients received L-DOPA preparations (Nacom); 15 subjects out of these 35 received them at a daily dosage up to 500 mg of Levodopa; 13 patients received 500-1,000 mg and 7 took in 1,000 mg and more; within the context of Nacom treatment 12 patients developed dyskinesias (in the form of dystony and choreiform hyperkinesia) that substantially impaired the motor function. The duration of treatment with amino acid compounds was 4-7 weeks (5.5 weeks on an average).

STUDY RESULTS

Following the course of treatment with amino acid compounds, the condition improved in 45 out of 53 patients (85%). Reduced akinesia and rigidity was recorded in 40 out of 46 patients (87%) with the akinetic-rigid syndrome; diminished tremor was found in 33 out of 42 patients (79%) with the shaking syndrome. The positive clinical dynamics enabled 13 out of 35 patients who received Nacom (37%) to cut the drug dose by an average of 1 tablet. Thereby, the patients showed increased motor activity. Besides, patients reported that the treatment with amino acid compounds accelerated and prolonged the Nacom action. At the same time, the use of amino acids was followed in 8 out of 12 patients (67%) by a decrease in side effects of Nacom (dyskinesias) which caused their motor function to improve. No patient examined was found to have any complications resulting from the intake of amino acid compounds. Many patients reported increased working capacity, better mood and appetite, normalized sl

As an example, we cite the following observation. The patient D., a 55 year old woman, case history No. 2462 with the diagnosis Parkinson's disease, rigid-shaking form, dyskinesia (choreiform hyperkinesis against the background of Nacom treatment) received amino acid compounds (Depark, Detrem)during 6 weeks. The disease history began about 8 years ago with right-sided hemiparkinsonism. For approximately 5 years, the patient has taken Nacom; the dosage in the last months amounted to about 5 tablets daily. In the treatment examination, the "switch-on - switch-off" syndrome was found (the "switch-on" occurred after 1 hr, and the "switch-off" after 2-2.5 hr following the intake of a Nacom tablet); in the "switch-off" phase there were pronounced manifestations of the akinetic-rigid and shaking syndrome, whereas in the "switch-on" phase choreiform hyperkinesis was recorded that impaired the motor activity and movement of the patient. In the treatment period, the Nacom dosage was cut to 3.5 tablets daily (reduction by 1.5 tablets); choreiform hyperkinesis manifestations, the shaking and akinetic-rigid syndromes decreased considerably; the Nacom action lasted up to 3-4 hours, the "switch-on - switch-off" syndrome became less marked. In a psychophysiological examination, a decrease of tremor by 2 times compared with initial tremor (prior to treatment) was recorded. Following the course of treatment, the patient reported an improvement of the general condition, better mood and normalization of sleep.

CONCLUSION

Thus, the course treatment with amino acid preparations during 4-7 weeks has produced a beneficial effect on most parkinsonism patients (85%). Reduced manifestations of the akinetic-rigid and/or shaking syndrome as well as an improvement of the general health were recorded. In patients who received Nacom before commencement of treatment, a longer Nacom action and reduced side effects (dyskinesias) were found; in the context of an improved general condition, some patients could substantially reduce the Nacom dosage.

REFERENCES

Melnichuk, P.V., Yakhno, N.N. Diseases with predominant impairment of the extrapyramidal system. In: Nervous system diseases, vol. 2, M., 1995, pp. 144-159 (in Russian).

Helme, R.D. Movement Disorders. In: Manual of Neurology. Fourth Edition. Edited by M.A. Samuels, Boston, 1993, pp. 316-337 (in English).


 
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