[Peony]

Has anyone here used Artane or Other Anticholinergic drugs, and if so what was your experience with it? I know there is concern about cognitive, hallucinations, etc., but it's supposed to be good for controlling tremor. Any personal experience would be appreciated.

[Jaye]

Hi, Peony,

Weekends are slow around here. I'm no expert on this topic, but I do know anti-c.'s should be carefully balanced with your other drugs. They are good for some of us and not necessarily good for others. Paula and others have recently done a lot of reading on the topic. i suggest you search for "anticholinergics" using "search" on the line of tasks near the top of this page. (mine is in white letters on a blue background band). Any trouble doing the search, or any other questions, let us know. Oh, and a great and famous neuro told me there's no evidence that they cause dementia.

Jaye

[lindylanka]

Hi Peony,
I use an anticholinergic medication for bladder urgency. My urologist said this class of drugs would have an effect on my PD. In combination with my PD drugs they bring an improvement that is only noticeable when I come off them (which I have done several times). They give side effects. These are sometimes mental/cognitive effects like abulia/apathy, drowsiness, daytime sleepiness, inattention, or not feeling engaged with the world. It depends on the dose, and which anticholinergic I am taking. I have tried a few as their effect is not sustained over long periods of time. If I stop using them and am only on L-dopa and entacapone (my PD regime) the effects go away completely. I am however less mobile, and my stride shortens, and I am a lot more rigid. I also get less pain. This is something I have chosen to live with as the better mobility outweighs this discomfort. And bladder urgency is no picnic. I do not know how they affect other people. This is just how they affect me. The ones I take are supposed to specifically target the bladder - but the effects are more general than the literature would have you believe.

I would agree with Jaye in thinking they do not cause dementia, as the effects disappear once the drug is discontinued.

I think this linking with dementia comes from studies of people with Alzheimer Disease. For some reason PD and AD seem to get inextricably linked in medical terms though there is a lot to say that PD dementia is often a result of medical treatments rather than the disease itself. It is a grey area in terms of information. My understanding is that with IPD intellect is intact till very late in the disease. This is not to say that there are components of IPD that may LOOK like dementia in the late stages, many of them related to ability to communicate and move, rather than being actual cognitive deficits. There are also PD-like variants which do feature dementia, the most obvious of these being Lewy body disease (LBD).

There are studies that indicate that people with AD who are removed from all drugs sometimes recover cognitive losses that had been attributed to disease progression, and some more enlightened care facilities are now using minimal drug regimes to optimise a slower decline.

In terms of effect on PD Paula has written loads on this, and a lot of it makes sense, she looked at possibilities of restoring balance of neurotransmitters, which recent study results would seem to confirm, especially those dealing with GABA. Acetylcholine and dopamine in the right balance help, along with other neurotransmitters, to create the smooth automatic movements we associate with moving freely and easily. When dopamine levels decline acetylcholine is relatively increased, creating a mismatch, anticholinergic medications reduce this mismatch, at least theoretically, and I believe, in my case, practically.

If you browse through some of the posts about this you will learn quite a bit, including just how diverse the thinking is on neurotransmitters. We are too different for absolutes to be true for all.

I know this does not answer your questions on Artane in particular, but again a good search should bring up posts that do discuss this....

Lindy

[RLSmi]

Peony;
Just a quick reply to add that, pre-sinemet in the 1950's and 60's, my mother, whose PD symptoms began in the late 1930's, leaned heavily on artane for relief of her tremor.

Prior to the introduction of artane, she used some really powerful belladonna alkaloids like scopolamine to relieve tremor.

One of the family stories that is still told recalls the time my older sister, then 4 years old, found mother's medicine and drank enough to poison herself to the extent that she was essentially blind. Fortunately, it was discovered quickly and a trip to the hospital for a stomach pump saved her.

Robert

[Peony]

I want to thank all of you for your very helpful remarks. I'm seeing a new neurologist soon to try to find some relief for my huge tremor, which also causes serious back, shoulder, & neck pain. So far, trials of several months with Sinemet & then Mirapex did nothing but cause intolerable side-effects. Other than the tremor, I'm actuallly doing pretty well. So I'm still searching.