- Health Canada has approved what some doctors are calling the most
significant drug for the treatment of Parkinson's disease in four
decades.
Azilect is not a cure for Parkinson's, but clinical trials have
shown it's highly effective in relieving the symptoms associated
with both the early and late stages of the disease, says a Montreal
neurologist.

Preliminary research also suggests the medication might even slow
the progression of Parkinson's, although this must be borne out by
further studies.

Gail Bereza, 67, a former day-care worker who has lived with the
disease since 1998, said her hand and leg tremors stopped after she
started taking the pill once a day in a clinical trial four years
ago.

"It's wonderful, marvellous," Bereza said from Windsor, Ont. "I'm
much happier. I have my life back."

More than 100,000 Canadians suffer from Parkinson's, a neuro-
degenerative disorder that causes shaking, weakness and severe
tremors. The disease robs the brain of cells that produce the
neurotransmitter dopamine.

For 40 years neurologists have treated patients with various
formulations of levodopa, a drug molecule that is transformed into
dopamine in the brain. Dopamine is a chemical that acts as a
messenger between brain cells that control movement. A decrease in
dopamine results in involuntary muscle contraction.

Michael Panisset, a neurologist at the Centre hospitalier de
l'Universite de Montreal, said Azilect can act as a stand-alone drug
or help make the standard levodopa more effective.

"I think this drug will be important in many respects," said
Panisset, co-director of the Clinique des troubles du mouvement at
Montreal's Hotel Dieu Hospital. "It's been shown to be really good
in the early onset of the disease and helpful in the later stages,
when patients start to have fluctuations. This drug will help
stabilize their response to levodopa."

For reasons that are still unclear to neurologists, an enzyme in the
body -- called monoamine oxidase type B -- degrades levodopa in the
brain. Azilect is part of a new class of drugs called monoamine
oxidase inhibitors, which prevent the enzyme from interfering with
levodopa.

Azilect might also act as a form of artificial dopamine, protecting
the brain as well as making levodopa more efficient, Panisset said.

People with Parkinson's, especially in the later stages, fluctuate
between on-stages, when they respond well to their medications, and
off-stages, when they suffer from tremors.

"With this medication, we've seen a decrease in the number of off-
periods," said Panisset, who was in charge of 20 patients at his
clinic who took Azilect as part of a trial. "As a result, the
patients are more active."

A month's supply costs $250 to $300, cheaper that other anti-
Parkinson's medications.

Aaron Derfel,
September 29, 2006 (Montreal Gazette)