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07-08-2017, 09:43 AM | #1 | ||
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Italian study.
Mucuna pruriens in Parkinson disease: A double-blind, randomized, controlled, crossover study. Mucuna pruriens in Parkinson disease Mucuna Pruriens Therapy in Parkinson's Disease - Full Text View - ClinicalTrials.gov Mucuna pruriens in Parkinson disease: A double-blind, randomized, controlled, crossover study. - PubMed - NCBI |
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"Thanks for this!" says: | eds195 (07-08-2017), GerryW (07-08-2017), hercules957 (07-09-2017), johnt (07-08-2017), Tryguy (07-08-2017) |
07-09-2017, 11:27 AM | #2 | ||
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A very interesting paper.
The paper referenced by the OP states: "Single-dose MP [mucuna pruriens] intake met all noninferiority efficacy and safety outcome measures in comparison to dispersible levodopa/benserazide." I take this to mean that the choice of whether to use MP or levodopa and either benserazide or carbidopa comes down to cost and convenience. Whenever I read about the effectiveness of mucuna pruriens I don't know whether to laugh or cry. On the one hand, mucuna pruriens is very effective even without a DCCI (such as carbidopa or benserazide), or any fancy processing: you can take a seed, roast it, grind it and mix it with water and you have a self-evidently effective therapy - no fancy trial designs or fancy statistics are required to show that it "works". Everyone on this forum could have discovered the benefits of mucuna pruriens for themselves. On the other hand, the therapeutic power of mucuna pruriens was missed for years, leaving many millions of people to be poorly medicated. On balance, I suppose we should take encouragement. If one low tech therapy has been found, others are likely waiting to be unearthed. But only if we look. John
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Born 1955. Diagnosed PD 2005. Meds 2010-Nov 2016: Stalevo(75 mg) x 4, ropinirole xl 16 mg, rasagiline 1 mg Current meds: Stalevo(75 mg) x 5, ropinirole xl 8 mg, rasagiline 1 mg |
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"Thanks for this!" says: | badboy99 (07-10-2017) |
07-09-2017, 02:09 PM | #3 | ||
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I may not have it right, but I am under the impression that carbidopa is the source of dyskinesia but you need it with the levodopa to avoid nausea. Do you know of anyone who does not take it with l-dopa? Thanks.
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07-09-2017, 03:43 PM | #4 | ||
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If you take levodopa on its own, much of it will be metabolised by DCC into dopamine before it gets to the brain. Dopamine cannot cross the BBB, so unless it is created in the brain it is wasted. Any dopamine formed outside the brain has the side-effect of causing nausea.
If a DCC inhibitor is used, less of the levodopa is metabolised outside of the brain, thus decreasing the nausea felt. Furthermore, if a DCC inhibitor is used, more of the levodopa gets into the brain, where it an be metabolised into dopamine. I don't think that it is quite right to say that the inhibitor causes dyskinesia, rather the effect of the inhibitor is to increase levodopa levels, and hence dopamine levels, in the brain. If these become too high, it leads to levodopa induced dyskinesia. The question about mucuna pruriens is why does it for a given level of levodopa appear to cause less nausea? John
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Born 1955. Diagnosed PD 2005. Meds 2010-Nov 2016: Stalevo(75 mg) x 4, ropinirole xl 16 mg, rasagiline 1 mg Current meds: Stalevo(75 mg) x 5, ropinirole xl 8 mg, rasagiline 1 mg |
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07-09-2017, 04:11 PM | #5 | ||
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I can add from a personal experience that we have used mucuna powder for years, as an add-on to sinemet. I have posted here about it before, so you can search the forum for my past posts about this.
Years on, we still take it, and the reasons are still pretty much the same: 1. it will take effect, reliably, which has become more of an issue as we're further into this illness, because sinemet doesn't always (and increasingly frequently, never) takes effect (read: waiting around, stuck and miserable, waiting for sinemet to kick in...waiting....waiting); 2. it will take effect even if we've eaten; 3. it will take effect within 15 minutes usually, which is great if you're frozen or just stuck; 4. it is cheap: a one pound bag of ground mucuna is around $25.00, including shipping, from Banyan Botanicals (no relationship to this company other than years as a mucuna customer!); 5. the bag will lasts a long time: our dose is a Tablespoon whenever we need it (mixed in a small Dixie cup with water...tastes horrible, so have something else ready to drink as soon as you take the mucuna, to get that taste out of your mouth. A few times we made milkshakes and put the mucuna in there, which was delicious and did mask the mucuna taste, but you lose a lot in the blender as it sticks to the sides and of course, one can't be drinking a milkshake two or three times every single day!). Our doc has been great about letting us set the mucuna schedule, since the alternative is to up the sinemet which none of us wants to do unless absolutely necessary. I've never done the calculations, but a one pound bag of mucuna has a loooot of tablespoon-sized doses in it. I don't know where we would be if we didn't have mucuna, it's been that helpful. I know we'd be taking a lot more sinemet, and although we have had to increase that over the years, I believe that increase has been a lot less because of the mucuna. I hope this helps others. FWIW, we have tried almost everything out there, and nothing helped us except mucuna. Also should know that mucuna hits quickly, but also wears off just as fast, so you could be left in a bad way unless you've planned accordingly (back-up mucuna, overlap mucuna with sinemet dose, be home and piled on the sofa when it wears off, etc.) Last edited by lurkingforacure; 07-09-2017 at 04:15 PM. Reason: clarification |
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07-10-2017, 07:12 AM | #6 | ||
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"When compared to LD+DDCI, MP-Ld showed similar motor response with fewer dyskinesias and AEs, while MP-Hd induced greater motor improvement at 90 and 180 minutes, longer ON duration, and fewer dyskinesias."
For me, the question about mucuna pruriens is why does it for a given level of levodopa appear to cause less dyskinesia? |
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"Thanks for this!" says: | moondaughter (07-10-2017) |
09-01-2017, 10:48 PM | #7 | ||
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Quote:
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