Neurologist can offer answers

Dear Dr. Gott: I was very intrigued by your article on how nicotine might help alleviate the symptoms of some diseases, especially since my wife has been trying to cope with her Parkinson’s disease.

I was able, with some effort, to copy the article from The Economist that you mention is the source of your information on the subject. After reading the article a few times, my interpretation of its contents and specifics are different from your conclusion. Please set me straight in my thinking.

The article from The Economist mentions that the drug nicotine may be used to help patients with Parkinson’s, Alzheimer’s and Tourette’s syndrome. A sentence used in the article may be misleading since it says “those studies suggest that nicotine administered by injection or by a skin patch can alleviate the symptoms not only of Parkinson’s disease, but also of Alzheimer’s disease and Tourette’s syndrome.”

Later in the article they refer to University of Vermont psychiatrists “administering the stuff (nicotine) to their Parkinson’s and Alzheimer’s patients.” But it does not reveal how the “stuff” was administered. The rest of the paragraph refers to the observation that following the administration of nicotine some symptoms were relieved. This might be referring to an injection or some type of single “dose” of nicotine after which improvement was immediately seen.

Further along in the article (the only part that refers to experimentation with a nicotine patch), there is a reference to Dr. Sanberg’s explanation about how the nicotine patch acts as a dopamine inhibitor by flooding the receptors and forcing them to shut down, since the patch is a continuous administration of nicotine. Thus it becomes a treatment for Tourette’s syndrome, which relies on inhibiting dopamine receptors to accomplish relief from symptoms.

I am no doctor, I’m an accountant who is very cautious about any medications. But it would seem to me that if a continuous dose of nicotine helps Tourette’s syndrome by forcing the dopamine receptors to shut down, then wouldn’t it follow that it would be a hindrance to Parkinson’s patients whose brains are starving for enhanced dopamine reception? Please let me know where my logic is flawed, since I am anxious to help my wife. Must I look to third parties for their assistance?

Dear Reader: I certainly encourage you to seek “third parties for their assistance.”

In the article to which you refer, I mentioned that scientists had discovered that nicotine (in patches or injections) can help patients with Parkinson’s disease. I am not aware of this nicotine therapy for Tourette’s syndrome. I do not believe that your “logic is flawed,” but I do recommend that you develop and refine a suitable therapy for your wife’s Parkinson’s.

My role as a medical columnist is to educate, not to judge. Thus, questions about your wife’s medical problem should be addressed by her neurologist.