Acta Scientific Neurology (ASNE) (ISSN: 2582-1121)

Research Article Volume 5 Issue 11

Biochemistry of Methylphenidate in Long-term Treatment of Parkinson’s

Robert W Townsend*

Independent Unaffiliated Neurobiochemistry Researcher/Author, Clinical Mental Health Specialist, and Private Clinic Proprietor, USA

*Corresponding Author: Robert W Townsend, Independent Unaffiliated Neurobiochemistry Researcher/Author, Clinical Mental Health Specialist, and Private Clinic Proprietor, USA.

Received: October 11, 2022; Published: November 08, 2022

Abstract

Introduction: Background: Discoveries in this study can significantly improve the health and quality of life of over ten million Parkinson’s- affected people. Clinicians prescribe AntiParkinsonian medications to treat Parkinson’s illnesses and Parkinsonism. AntiParkinsonian Carbidopa-Levodopa, Ropinirole, and Pramipexole commonly cause progressive neural damage (augmentation) and adverse reactions such as excessive sedation, sudden passing out, and slowed cognition. This study presents a neurobiochemistry analysis regarding the world’s first long-term treatment of Parkinson’s with Methylphenidate. The neurobiochemistry analysis in this study describes and explains how Methylphenidate adjunctive therapy counteracts the adverse effects of AntiParkinsonians and how Methylphenidate monotherapy controls motor and non-motor symptoms, strengthens neural tissues, sustains alertness and cognition, and slows progressive worsening. Clinical uses of Methylphenidate rarely cause side effects and they are virtually always minor. Methylphenidate is prescribed to millions of children as young as 6 years.

Methods: This article analyzes the neurobiochemistry of Methylphenidate vs. AntiParkinsonian therapy based on a review of over 400 published articles and a 17-year treatment for severe Parkinson’s/Parkinsonism with nine years of AntiParkinsonians followed by eight years of Methylphenidate. The recipient, Dr R, is a 66-year-old PhD American male who is a published Researcher. At age-55 he was documented as disabled and needing medications to function. At age- 58 his illness and the adverse effects of APs jointly caused total disability for which there was no medication or remedy. Thus he conceived and designed the world’s first long-term Methylphenidate treatment of Parkinson’s. He implemented it with the cooperation of a prescribing Physician.

Results: Initial experimentation found that 30 mg doses of Methylphenidate overcame the adverse effects of adjunctive AntiParkinsonians. Continued experimentation later found that 20 mg doses of Methylphenidate monotherapy controlled Parkinson’s illness-symptoms better than AntiParkinsonians. An experimental 3-hour dosing schedule resulted in uninterrupted efficacy during transitions between doses. Efficacy duration was extended to 16 hours by adding sequential doses every three hours. A 25 mg dose upon waking overcame residual morning grogginess from high-dose AntiParkinsonians at bedtime that gave good sleep. Six years of gradual titration resulted in an optimally effective daily regimen of: [dose-1, 3-hour MPH-IR 25 mg], [dose-2, 6-hour MPH-ER 40 mg], [dose-3, 3-hour MPH-IR 20 mg], [dose-4, 3-hour MPH-IR 20 mg], [bedtime 2 tabs Carb-Levo 10/100 mg, 2 tabs Carb-Levo ER 25/100 mg, and 2 tabs Pramipexole 0.25 mg].

Conclusion: Clinicians can replace diurnal AntiParkinsonians with diurnal Methylphenidate in order to provide safer and more effective long-term treatment of Parkinson’s illnesses and Parkinsonism.

Keywords:AntiParkinsonians; Dopamine; Methylphenidate; Narcolepsy; Parkinson’s; Pramipexole

References

  1. Parkinson’s Foundation. “Surgical Treatment Options”. Parkinson's Foundation (2022).
  2. Parkinson’s “About Parkinson's Disease”. Parkinson Foundation (2022).
  3. Kramer Stephanie. “With Billions Confined to Their Homes Worldwide, Which Living Arrangements Are Most Common?” Pew Research Center (2020).
  4. GSK group of companies. Requip/Ropinirole Product Monograph (2020).
  5. Merck Sharp and Dohme Corp. Sinemet/Carbidopa-Levodopa Product Monograph (2020).
  6. Boehringer Ingelheim International Mirapex/Pramipexole product monograph (2021).
  7. Persico AM., et al. “Parkinsonian patients report blunted subjective effects of methylphenidate”. Experimental and Clinical Psychopharmacology 6 (1998): 54-63.
  8. Camicioli , et al. “Methylphenidate Increases the Motor Effects of L-Dopa in Parkinson's Disease: A Pilot Study”. Clinical Neuropharmacology 24.4 (2001) 208-213.
  9. Nutt J., et al. “Effects of Methylphenidate on Response to Oral Levodopa, A Double-Blind Clinical Trial”. Archives of Neurology 3 (2007): 319-323.
  10. Loddo , et al. “The Treatment of Sleep Disorders in Parkinson’s Disease: From Research to Clinical Practice”. Frontiers in Neurology (2017).
  11. Lopez R., et al. “Test-Retest Reliability of the Multiple Sleep Latency Test in Central Disorders of Hypersomnolence”. SLEEP 12 (2007).
  12. Trotti , et al. “Test-Retest Reliability of the Multiple Sleep Latency Test in Narcolepsy without Cataplexy and Idiopathic Hypersomnia”. Journal of Clinical Sleep Medicine 9.8 (2013).
  13. Zhang L., et al. “Freezing of Gait in Parkinsonism and its Potential Drug Treatment”. Current Neuropharmacology 4 (2016): 302-306.
  14. Moreau C., et al. “Methylphenidate for gait hypokinesia and freezing in patients with Parkinson's disease undergoing subthalamic stimulation: a multicentre, parallel, randomised, placebo-controlled trial”. Neurology 7 (2012): 589-596.
  15. Devos , et al. “Improvement of gait by chronic, high doses of methylphenidate in patients with advanced Parkinson’s disease”. Journal of Neurology, Neurosurgery, and Psychiatry 78 (2007): 470-475.
  16. Penn State Health Milton Hershey Medical “Parkinson Disease”. Parkinsons (2022).
  17. MacDonald P., et al. “The effect of dopamine therapy on ventral and dorsal striatum- mediated cognition in Parkinson's disease: support from functional MRI”. Brain 5 (2011): 1447.
  18. Novartis Pharmaceuticals Corporation. “Ritalin/Methylphenidate product monograph 2019”. Novartis Pharmaceuticals Corporation (2022).
  19. Novartis Pharmaceuticals Corporation. “Ritalin/Methylphenidate product monograph 2015”. Novartis Pharmaceuticals Corporation (2019).
  20. Volz T. “Neuropharmacological Mechanisms Underlying the Neuroprotective Effects of Methylphenidate” Current Neuropharmacology4 (2008): 379-385.
  21. “CADDRA Guide to ADHD Pharmacological Treatments in Canada 2016”. CADDRA Version 2015 (2016).
  22. “CADDRA. Canada ADHD Practice Guidelines 2019” CADDRA Version (2020).
  23. Purdue “Foquest product monograph March 2019”. Purdue Pharmaceuticals (2019).
  24. Purdue Pharmaceuticals LP. “Adhansia XR product monograph 2019”. Purdue Pharmaceuticals (2019).
  25. Houghton D., et al. “Parkinson’s Disease Medications”. Parkinson’s Foundation website article (2018).
  26. Huss M., et al. “Methylphenidate dose optimization for ADHD treatment: review of safety, efficacy, and clinical necessity”. Neuropsychiatric Disease and Treatment 13 (2017): 1741-1751.
  27. ADHD “ADHD Medication Calculator/Converter for Healthcare Professionals only”. MedCalc (2017).
  28. National Health Service United Kingdom (NHS UK). “Methylphenidate for adults”. National Health Service United Kingdom website article (2021).
  29. National Health Service United Kingdom (NHS UK). “Methylphenidate for children”. National Health Service United Kingdom website article (2021).
  30. Novartis Pharmaceuticals “Ritalin LA product monograph 2021”. Novartis Pharmaceuticals Corporation (2021).
  31. Adjei Akwete., et al. “Single-dose pharmacokinetics of methylphenidate extended-release multiple layer beads administered as intact capsule or sprinkles versus methylphenidate immediate-release tablets (Ritalin®) in healthy adult volunteers”. Journal of Child and Adolescent Psychopharmacology 10 (2014): 570-578.
  32. Swanson , et al. “Efficacy of a Pattern of Delivery of Methylphenidate for the Treatment of ADHD: Effects on Activity Level in the Classroom and on the Playground”. Journal of the American Academy of Child and Adolescent Psychiatry 41.11 (2021): 1306-1314.
  33. Katzman M., et al. “Randomized Controlled Crossover Trials of the Pharmacokinetics of PRC-063, a Novel Multilayer Extended-Release Formulation of Methylphenidate, in Healthy Adults”. Journal of Clinical Psychopharmacology6 (2020): 579-587.
  34. Masand PS and Tesar GE. “Use of stimulants in the medically ill”. Psychiatric Clinics of North America 19 (1996): 515-547.
  35. Challman T and Lipsky J. “Methylphenidate: Its Pharmacology and Uses”. Mayo Clinic Proceedings 75 (2000): 711-721.

Citation

Citation: Robert W Townsend. “Biochemistry of Methylphenidate in Long-term Treatment of Parkinson’s". Acta Scientific Neurology 5.12 (2022): 12-32.

Copyright

Copyright: © 2022 Robert W Townsend. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.




Metrics

Acceptance rate32%
Acceptance to publication20-30 days

Indexed In




News and Events


  • Certification for Review
    Acta Scientific certifies the Editors/reviewers for their review done towards the assigned articles of the respective journals.
  • Submission Timeline for Upcoming Issue
    The last date for submission of articles for regular Issues is December 25, 2024.
  • Publication Certificate
    Authors will be issued a "Publication Certificate" as a mark of appreciation for publishing their work.
  • Best Article of the Issue
    The Editors will elect one Best Article after each issue release. The authors of this article will be provided with a certificate of "Best Article of the Issue"

Contact US