At what point would a drug like this new one and the other cholinesterase inhibitors [aricept, exelon, etc.] be prescribed? What determines the need for these drugs in a pd patient? i was given it just because of an off the cuff remark about azilect keeping me sharp and focused.

Isn't that a bit of an overkill to prescribe this for a little comment made? an observation? I took no mini mental test for this drug.

So does anyone know what determines that a pwp is demented enough to need these drugs? I think there is a reason they call the pwp community high achievers and smart as a chronically ill group.

It's as Lindy said, we have brain dysfunction, cognitive fog, loss of inhibitory mechanisms and impulse control, executive function, and more. But we do not have dementia in the way a typical person would envision it. Thus we are still here , getting smarter everyday by the way, just can't write, memory needs some help, can't make decisions, etc. But i am in my right mind as they say. We stay sharp because we are not low in acetylcholine.

However we do not want to overdose on acetycholine.

The last statement is more important than anyone realizes -pesticides bind to the cholinergic enzyme , thus allowing more acetylcholine in pwp. So we have the cognitive transmitter on overdrive, working against the dopamine, but still we stay smart. At first we are normal; then pesticides attack our cholinergic enzyme causing too much acetylcholine.

We spend the reset of our lives looking for a balance.

So what determines when a pwp might be lacking acetylcholine? Shouldn't they have severe deficits in memory - like forgetting where they are going or not recognizing relatives?

I think they should work on research /therapy to balance the transmitters and determine if high acetylcholine can diagnose pd in combination with other things. Logically we need something to keep acetylcholine low without the cognitive fog.

This drug may be different. But it seems like all they are working on is dementia with pd and alzheimers, as if they are the same.