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In 1973, the famous neurologist Oliver Sacks published his memoir Awakenings, later made into a movie of the same name starring Robin Williams. In the book, Dr. Sacks described his experiences administering the then-new medication L-dopa to a group of catatonic patients who had survived an 1917-1918 epidemic of a disease known as encephalitis lethargica.
For over 40 years, these unfortunates had been unable to speak, to move out of their chairs, to express emotion, or to respond to human touch. Sacks, who had previously (in real life) extracted the neurochemical L-dopa from earthworm brains, decided to try L-dopa treatment as a remedy for their decades-long paralysis.
In the movie, one patient begins to communicate by operating a Ouija board. This patient and others regain their ability to speak, to move, to enjoy a trip to the Boardwalk or a picnic in the park, and to fall in love. One by one, however, their newly rediscovered powers of movement degenerate into tics and spasms, until in the end each patient is once again unable to move, or speak, or express emotion.
What had happened (in real life) to the patients of the distinguished Dr. Sacks is that the L-dopa treatment had essentially "burned out" neural circuits in the brain. While L-dopa in the treatment of Parkinson's disease does not cause dramatic effects of these tragic dimensions, treatment with L-dopa (sold in some countries under the trade name Artane) is severely problematic. L-dopa side effects include:
- Hypersexuality, with loss of inhibitions and sense of social propriety.
- Anxiety, often with paranoid overtones, which may be directed at family and caregivers.
- Nausea and constipation, which are often severe.
- Insomnia alternating with vivid dreams.
- "Sundowning," loss of sense of time, getting up at sundown as if it were early morning.
- Hallucinations, both visual and auditory.
After several weeks to several months of taking the drug, side effects may include:
- Severe deterioration of symptoms as each dose of the drug wears off.
- Dyskinesia, tics, and spasms, mainly in the upper body.
- Serotonin depletion, leading to depression, and worsening constipation.
- Freezing during movement, becoming catatonic in the middle of a stride while walking, becoming voiceless in the middle of a sentence, getting stuck in a chair.
Just a few weeks of taking L-dopa can result in dopamine dysregulation syndrome, in which patients crave the medication and give themselves extra doses. Often this self-medication is accompanied by sexual addiction, gambling addiction, food addiction, or kleptomania that is inconsistent with the Parkinson's patient's character and lifestyle.
Typically, Parkinson's patients find that the benefits of L-dopa are short-lived and its side effects are serious. The Ayurvedic herb Mucuna pruriens, however, offers a naturally occuring L-dopa in small doses that don't cause these problems.