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Expert Pearls

Parkinson's Disease - acetyl-L-carnitine, alpha lipoic acid, melatonin - 50271

Melatonin (slow-release) 2mg at night; plus alpha lipoic acid 200-400 mg per day and acetyl-L-carnitine 250-500 mg per day, both taken together, starting with the lower dose, right after a meal, and in divided doses for the higher dose; plus Coenzyme Q10 200 mg per day, rising slowly (month by month) until control is achieved, not exceeding 800 mg maximum per day, in divided doses, then 200-400 mg per day as maintenance dose / in divided doses; plus vitamin E (400IU once a day with coenzyme Q); and acetyl-L-carnitine 250 mg at night is a safe combination therapy and should be continued for a year before seeing appreciable disease control. [Neurobiol Aging, 2013 Oct 10. [Epub ahead of print] 50271] Interview PubMed

Parkinson's Disease - coq10 - 49828

CoQ10 (ubiquinone and ubiquinol) 400-2400 mg per day in a single dose with meals in early Parkinson’s disease patients reduced symptoms and oxidative stress after 2 weeks, except the 2400 mg increased F2-isoprostanes (oxidative stress marker). There were no side effects and compliance was high. [Antiox Redox Signal, 2014 Jan 11; [Epub ahead of print]. 49828 (4/2014)] Summary Interview PubMed

Parkinson's Disease - n-acetylcysteine - 50745

N-acetylcysteine orally at 35 mg/kg and 70 mg/kg given twice daily for two days in either 1) liquid form (20% solution, USP verified), or 2) capsule form (compounded by the UCSF pharmacy using USP verified NAC in powder form) usually with food, showed a dose dependent rise in CSF NAC and was well tolerated. [Parkinsonism Relat Disord. 2015 Feb 28. 50745 (4/2015)] Interview PubMed

Parkinson’s Disease - Glutathione

Glutathione (reduced) 600 mg intravenously (I.V.) twice daily for 30 days resulted in 42% decline in disability. The improvement was seen after 3 weeks and particularly significant for rigidity and hypokinesia. Once GSH was stopped the therapeutic effect lasted for 2-4 months. [Prog Neuro-Psychopharmacol & Biol Psychiat 1996;20:1159-1170. 34377 (2000)] Summary Interview

Parkinson’s Disease - Glutathione - 2

Glutathione parenterally, usually intravenously. [J Applied Nutr, 1999;51(1):3-15. 34948 (2000)] Summary Interview

Parkinson’s Disease - Glutathione - 3

Glutathione - significant decrease in the level of reduced glutathione (GSH) in substantia nigra. [Prog Neuro-Psychopharmacol & Biol Psychiat 1996;20:1159-1170. 34377 (2000)] Summary Interview

Parkinson’s Disease - Mitochondria

Mitochondrial energy production deficit (acetyl-l-carnitine, CoQ10, phosphatidylserine, magnesium enhance mitochondrial ATP production). [J Applied Nutr, 1999;51(1):3-15. 34948 (2000)] Summary Interview

Parkinson’s Disease - Pesticide

Pesticide exposure. [J Applied Nutr, 1999;51(1):3-15. 34948 (2000)] Summary Interview

Parkinson’s Disease - Transcranial Magnetic Stimulation

Transcranial Magnetic Stimulation (rTMS) drugs + rTMS (1 Hz, 0.6 T, 100 stimuli per day for 7 days using a round coil). rTMS was repeated at least twice each year for 3 years. [Brain Research Bulletin, 2004;64:259-263. 42403 (01/2005)] Summary Interview

Parkinson’s Disease - caffeine, coffee - 50531

Coffee drinking/caffeine intake was protective against Parkinson’s disease and those with GRIN2A genotype may receive additional benefit from coffee/caffeine intake. [PLoS One. 2014 Jun 10;9(6): e99294. 50531 (10/2014)] Interview PubMed
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