The effect of maintenance medication on the higher serum cortisol concentration of parkinsonism (Purkiss AG et al. Br J Clin Pharmac 1996;42:in press) was examined in 96 patients. There was no relationship of the resting concentration, adjusted for sampling time, to time since diagnosis (range 0 to 288 months, P=0.3), and whether patients were receiving anti-parkinsonian medication (81) or not (P=0.96). Although levodopa (79 patients) and direct agonists (20) had no effect, cortisol was lower with 1-deprenyl (52) or antimuscarinics (16) (P=0.048 and 0.02, respectively). Those prescribed laxatives (20) for marked constipation had higher concentrations (P=0.04). No interaction between medicinal effects was detected (5 patients 1-deprenyl with antimuscarinic and 11 with laxative; 0 antimuscarinic with laxative; 2 all three). Moreover, in a model describing prescription of all three types of medication, the directions of the effects (P=0.01, 0.02 and 0.08) were the same. The contrast (95% C.I.) in cortisol of those receiving to those not receiving was 0.85 (0.74,0.97) for 1-deprenyl, 0.81 (0.68, 0.97) for antimuscarinics, and 1.16 (0.98, 1.36) for laxatives. Bowel stasis has been implicated in the aetiology (Purkiss AG et al. Ibid 1995;41:457-8P). The model withstood exclusion of 2 patients whose antimuscarinic was also anti-histaminic. L-deprenyl and antimuscarinics may modify the disease process.
|Number of pages||1|
|Journal||Clinical Pharmacology and Therapeutics|
|Publication status||Published - 1997|