Wednesday, October 25, 2006

Michael J. Fox Is Right

This is a devastating ad. The GOP's Mighty Wurlitzer is warming up and delivering a full frontal assault on Michael J. Fox in an attempt to reduce the effectiveness of this ad.

Rush Limbaugh (who knows a lot of pharmacology, but only the ones treating pain and erectile dysfunction) is accusing Fox of going off his medications in order to exaggerate the devastating effects of Parkinson's disease for political gain. He obviously knows nothing about the treatment for Parkinson's disease.

The jerking and swaying that you see on the video is called tardive dyskinesia and is a side effect of the medications used to treat Parkinson's disease. After decades of research, there is still no better treatment than oral levodopa. Parkinson's disease is currently thought to be related to depletion of dopamine in the corpus striatum in the central nervous system. Dopamine does not cross the blood-brain barrier, so it cannot be administered orally, but L-dopa does cross it and is metabolized into dopamine in the CNS; however, it requires tremendously high doses of L-dopa in order for sufficient amounts to cross the blood-brain barrier in order to have the desired effect.

The high levels of L-dopa cause intense nausea, tardive dyskinesia, and other negative effects. Carbidopa is a drug that reduces the amount of L-dopa required to have the desired effect by 75%, so it is a significant improvement in the treatment of Parkinson's disease.

Sinemet is a medication that is a combination of L-dopa and carbidopa, and has been approved for use since 1991. The fact that there has been no significant advancement in the treatment of Parkinson's in the last 15 years is very telling. The fact that young people, like Fox (ouch, I see 45 as being young!), are willing to live with these adverse effects - that their lives are better with these constant motions, nausea and vomiting is horrifying.

It is vital that every possible option for research is funded by the federal government, since the vast majority of medical advances have been made by federally-funded research. Expecting the private sector to bleed money for more than a decade is delusional. Medical research is by its very nature a slow and cautions activity. Rushing a treatment to market in order to maximize profitability can be disastrous. The Viagra debacle is proof of that concept - the only reason it remains on the market is that there is a very large portion of the population that is willing to risk death in order to prove that they can still "do what comes naturally". Can you imagine if a drug to treat ADD killed several children after it was rushed to market? I can picture the mobs with torches and pitchforks storming the gates of the drug manufacturers.

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