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Questions posted in the
Neurology and Neurosurgery Forum have been answered by doctors from The Cleveland Clinic Foundation.
Question Title: Dopamine and RitalinForum: Neurology Forum
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I was reading the November 30, 1998 issue of Time and came across a very interesting article. It seems that researchers suspect that Attention-deficit/hyperactivity disorder (ADHD) stems from an inadequate supply of dopamione and norepinephrine in the brain-a hypothesis that is supported in part by the fact that Ritalin boosts dopamine levels. My question would be this. Has anyone heard of any research done on the use of Ritalin with Parkinsons patients. The definetion of Parkinson's Disease below was taken from the medhelp.org website: Parkinson's disease is a degenerative disease of the nervous system which involves a very small region of the brain called the substantia nigra. This area is part of a complex group of circuits in the brain which are involved in movement, and in particular movements we generally are not conscious of -- such as posture, balance, the degree of stiffness or flexibility needed in a limb. With loss of cells in the substantia nigra, a key neurotransmitter -- dopamine -- becomes deficient, and patients develop problems with stiffness, decreased movements, tremor, falling and decreased facial expression. Any help in this matter is greatly appreciated.
= There is unfortunately a key difference between the two disorders which makes the Ritalin theory unlikely to work. There is not a lack of dopamine in the brain as a whole in Parkinsons disease, the problem is with delivery of dopamine to specific sites in the brain by the cells which have degenerated in the substantia nigra. The therapies to treat Parkinsons disease essentially flood the brain with substances which either replace or act as precursors for dopamine at the appropriate sites. The degree to which Ritilan increases dopamine level inadaquete to achieve this global increase and the area in which it acts maximally is unfortunately not the specific area, the substantia nigra, where the effect is required in Parkinsons disease. Ritilan has been tried to help mood disorders in Parkinsons disease but had no effect on the disease itself. Unfortunately the article in Time gives no idea of the complexity of the neurotransmitter substances in the brain and their variability from one anatomical area of functional subsystem to another, I wish it wa so straightforward !
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