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Tuesday, September 30, 2014
I wondered when/if entacapone would be approved for sale in this country. My pwp cannot take any of the agonists because of paranoia/hallucinations caused by any increase in sinemet. He is only on 3 25/100 sinemet a day and the only reason he can handle this small amount is due to the fact that he is on seroquel.
Entacapone is undergoing the FDA approval process and should be available in the USA in the near future. One thing to remember though: entacapone acts by increasing the availability of Sinemet. Thus adding it on to Sinemet helps reduce on-off fluctuations but can also worsen dyskinesias and hallucinations. Increasing the dose of Seroquel may help control hallucinations better. Surgery, particularly pallidotomy, may be helpful in controlling dyskinesias.
Arif Dalvi, MD
College of Medicine
University of Cincinnati