Natural treatments for Parkinson's
Q) Do you have any info on the side-effects of Requip prescribed for my Parkinson's? Are natural remedies available and effect-ive?-M.H., via e-mail
A) You say you've recently been diagnosed with Parkinson's disease (PD). The first thing you might do is get a second opinion, as the condition is notoriously difficult to diagnose: one in four people given a diagnosis of PD don't actually have it (Arch Neurol, 1999. 56: 33-9).
You'd imagine that a brain scan might be definitive, but PD doesn't show up on either MRI or CT-though PET scans do show promise.
So, doctors usually can only deduce PD from a list of symptoms, but that's not infallible. For example, tremor is a common symptom, but there are a dozen different kinds of tremors, none of them due to Parkinson's. Also, if you are already taking any drugs, some drug side-effects mimic PD symptoms (J Clin Neurophysiol, 1996; 13: 122-32).
You've been prescribed Requip (ropinirole), made by Glaxo. In its pre-marketing trials, there were 11 clinical trials, but Glaxo has only reported on three of them. Even then, the results were unspectacular with, at most, a third of PD patients significantly deriving any benefit-and then, only for six months.
"Ropinirole controls the symptoms of Parkinson's disease, but does not cure it," acknowledges Glaxo modestly. And it has much to be modest about, for the list of ropinirole's side-effects is huge, and includes some that seem to be worse than the condition itself, such as suddenly falling asleep, extreme fatigue, involuntary movements and tremors, high temperature and sweat-ing, extreme nausea, rigid muscles, arthritic pain, limb swelling, bloating, dizziness, hallucinations and paranoia, loss of consciousness and compulsive behaviour (such as gambling and sex).
In the clinical trials, around 25 per cent of the participants dropped out due to the side-effects. But some patients have found that their side-effects are irreversible. Even after stopping the drug, the adverse effects can persist for weeks or even months.
So, it's a good idea to ask if there are any natural, alternative remedies. The antioxidant coenzyme Q10 has been found to be of particular value especially in the early stages of the disease. You'll need to take a lot of it, though: 1200 mg/day was the optimal dose in a placebo-controlled trial by the Department of Neurosciences at the University of California at San Diego. It can't cure PD, but it can slow its progression (Arch Neurol, 2002; 59: 1541-50).
Again, as you're likely to be in the early stages of the disease, vitamin B6 may also prove helpful. Doctors in the Netherlands have recently found that
a diet high in vitamin B6 (found in avocados, potatoes, bananas, fish and chicken) can offer significant protec-tion against PD (Neurology, 2006; 67: 315- 8). This finding makes sense, as B6 raises dopamine levels in the brain, a lack of which is central to the disease. A sensible dose is 50 mg/day, but you should check with your doctor first as you're also taking PD drugs, too.
Intravenous NADH, another B vita-min coenzyme, has been tested in small clinical studies-but, so far, with contradictory results. However, the theory says it should work, as NADH is thought to stimulate the body's own production of levodopa (J Neural Transm, 1996; 103: 1187-93; Acta Neurol Scand, 1994; 90: 345-7).
Vitamin E may also be useful, as the evidence suggests that it can protect against PD (Lancet Neurol, 2005; 4: 362-5).
But one non-drug treatment is head and shoulders above the rest. It's a plant remedy derived from a tropical vine, Mucuna pruriens, also known as the velvet bean. Used for centuries in Ayurvedic medicine, it has now been formulated in a powder form-called HP-200-for the Western market. In a large multicenter trial, a daily dose of about 40 g of HP-200 was found to considerably reduce the symptoms of Parkinson's, with only mild, mainly gastrointestinal, side-effects (J Altern Complement Med, 1995; 1: 249-55).
Recently, Mucuna was tested against levodopa, the standard PD treatment, by the UK's Institute of Neurology at Queen Square, London. Patients were randomly given single doses of 15 or 30 g of Mucuna one week, and single doses of 200 or 50 mg of standard levodopa/carbidopa the next week, and so on. The trial was randomized, so no one knew who was taking what. Mucuna worked faster and its benefits lasted longer than the standard drug treatment-with far fewer side-effects (J Neurol Neurosurg Psychiatry, 2004; 75: 1672-7).
Why is Mucuna so effective? It has a list of chemical constituents almost tailor-made to attack PD. The plant contains, among other things, large amounts of natural levodopa as well as serotonin, linoleic acid, niacin, NADH and Co-Q10. As has already been suggested, it's the last two agents in particular that researchers believe give Mucuna its special qualities.
Most exciting of all, rat experiments have demonstrated that Mucuna not only restores levodopa (and dopamine, norepinephrine and serotonin) in the brain, but actually stimulates the body's own natural production of it, too-it's "a neurorestorative benefit unlike synthetic l-dopa," say the Texan neurologists who made this break-through discovery (Phytother Res, 2004; 18: 706-12).
However, bear in mind that results in animals don't necessarily apply to humans. Nevertheless, getting the body to make its own levodopa could be good news for PD sufferers, as synthetic levodopa generally only works for about five years.
Finally, acupuncture has shown some success in patients with PD. In one recent study, two sessions a week for an average of about six weeks produced improvements in tremor, walking, handwriting, slowness, pain, sleep, depression and anxiety in 85 per cent of the study participants. Furthermore, there were no adverse effects (Mov Disord,2002; 17: 799-802).
So, two ancient alternative remedies, although not curative of this intractable disease, appear to offer the best hope yet for Parkinson's sufferers.