Area doctors comment on new drug for Parkinson's

August 23, 1997


Staff Writer

Mirapex, a new medication for treatment of Parkinson's disease, is the first new Parkinson's drug since 1989.

Approved by the Food and Drug Administration July 2, the drug mimics the actions of the brain-signaling chemical dopamine.

Parkinson's disease is a chronic, progressive neurological disorder that results from the degeneration of nerve cells in a region of the brain that controls movement. This creates a shortage of the dopamine, and can result in impaired movement.

The cause of the disorder is not known, but theories include inherited susceptibility and environmental factors. Although there is no cure, symptoms can be treated with medication.


John Ruane, spokesman for Pharmacia & Upjohn, the manufacturer of Mirapex, claims that the drug works in a manner that is dramatically different from the way other medications work. Mirapex is believed to target two of five dopamine receptors in the brain and bind to them. Stimulation of the receptors enhances motor skill function.

Parkinson's disease affects more than one million Americans. That's more than those with multiple sclerosis, muscular dystrophy or Lou Gehrig's disease combined. Symptoms usually begin at about age 60, but people in their 20s, 30s and 40s can be affected, according to American Parkinson Disease Association. It appears to be slightly more common in men than women.

The symptoms

People experience Parkinson's differently. Major symptoms include tremor - the trembling or shaking of a limb, especially when the body is at rest, slow movement, an inability to move, rigid limbs, a shuffling gait and stooped posture. People with Parkinson's often show reduced facial expression and speak in a soft voice.

In the early stages of Parkinson's, Mirapex can be used without the dopamine replacement drug usually prescribed. It also can be used in combination with the replacement drug for advanced Parkinson's disease.

Sinemet, a commonly used medication for Parkinson's, is a good drug, in the opinion of Dr. Nechama Bernhardt, a Hagerstown neurologist. It replaces what's missing. But one problem is its side effect of an on-off phenomenon - periods when patients have either a poor response or too much response to the drug, according to Bernhardt. She has not yet prescribed Mirapex, but believes that it's good to have medicines with different mechanics.

Dr. Merullah Khan, a Hagerstown neurologist, has prescribed Mirapex for a couple of his Parkinson's patients. Although he says it's too soon to know how well it's working, Khan also is happy to have another medication available, one that works in a different pathway.

Dr. Colin T. Iosso, a Martinsburg, W.Va. neurologist, says he'll wait until Mirapex is on the market awhile longer before prescribing it. He's interested in seeing what its side effects might be and doesn't see the drug as a miracle breakthrough.

"I see it as another weapon in the fight against Parkinson's disease," Iosso says.


For information, call Pharmacia & Upjohn's patient information line at 1-800-253-8600, extension 36004.

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