Saturday, October 31, 2009

New Concepts, Dangerous Beasts Slouching

The Second Coming

TURNING and turning in the widening gyre
The falcon cannot hear the falconer;
Things fall apart; the centre cannot hold;
Mere anarchy is loosed upon the world,
The blood-dimmed tide is loosed, and everywhere
The ceremony of innocence is drowned;
The best lack all conviction, while the worst
Are full of passionate intensity.

Surely some revelation is at hand;
Surely the Second Coming is at hand.
The Second Coming! Hardly are those words out
When a vast image out of Spiritus Mundi
Troubles my sight:  somewhere in sands of the desert
A shape with lion body and the head of a man,
A gaze blank and pitiless as the sun,
Is moving its slow thighs, while all about it
Reel shadows of the indignant desert birds.
The darkness drops again; but now I know
That twenty centuries of stony sleep
Were vexed to nightmare by a rocking cradle,
And what rough beast, its hour come round at last,
Slouches towards Bethlehem to be born?

Author: William Butler Yeats
Online Poetry at

Wednesday, October 28, 2009

Dopamine is irresistible to everything but serotonin

Natalie Angiers in the New York Times discusses in a trenchant and amusing fashion how dopamine is essential to motivate us to action. She neglects to point out that serotonin is the neurotransmitter that tells us when to stop. Jonah Lehrer complements her article on the Frontal Cortex website.

Here are my comments:

The addicted patient seeks dopamine not only to give pleasure but to relieve the pain of dopamine deficit. Unfortunately, increasing dopamine can itself be addictive or as Richard Pryor put it, "Cocaine makes a new man out of me and the new man wants cocaine." Fortunately, actually inevitably, there is a neurotransmitter that inhibits behavior, serotonin.

In 1993, I introduced Dr. Richard Rothman, director of National Institute of Addiction's Intramural Research Program in Baltimore, to the idea that combined dopamine and serotonin agonists
(CODAS) could treat addiction and other disorders. I have gone on and used levodopa and 5-HTP the precursors of dopamine and serotonin, as the best way to manage same. Richard has gone in another direction. In this recent article he reviews the rationale behind CODAS and the dual deficit model of addiction and discusses the development of an agent that can do this effectively.

Tuesday, October 20, 2009

Why 5-HTP and the PURSOR Protocol May Improve Parkinson's Disease Rx


The inevitable progression of Parkinson’s Disease (PD) is unresponsive to treatment. Dopamine (DA) agonists may promote the underlying neurodegenerative process. Combined 5‑hydroxytryoptophan (5-HTP), the immediate precursor of serotonin (5-HT), and levodopa therapy should block DA induced PD progression because DA and 5­­-HT have countervailing actions in the immune system. While DA promotes inflammatory Th1 cytokines, neurotoxicity and neural apoptosis (programmed cell death), 5-HT promotes anti-inflammatory Th2 cytokines, acts as a neuroprotectant, and is antiapoptotic. Combined DA and 5-HT precursor therapy (PURSOR) with levodopa and 5-HTP suspensions titrated by taste, already associated with unprecedented partial remissions in another neurodegenerative disorder, amyotrophic lateral sclerosis, should markedly improve symptomatic Parkinson’s treatment, decrease the incidence of levodopa toxicity, and, by restoring Th1/Th2 balance and putatively decreasing QUIN induced excitatory neurotoxicity, alleviate or even halt the progression of PD.

Seven Reasons:

A.      The buccal mucosal route permits both precursors to pass through the blood-brain barrier directly without first passing through the general circulation. Since this markedly diminishes the decarboxylation of either precursor prior to its entering the CNS, carbidopa is no longer necessary.
B.       Maximum therapeutic levodopa doses to assuage nigrostriatal DA deficiency should now be realized promptly and safely. Prior to the proprietary PURSOR protocol, the responsible clinician, concerned that increasing the levodopa dose could at any time induce severe adverse effects, knowing that the only clinical endpoints were the onset of levodopa toxicity or PD clinical improvement, recognizing there was no procedure to ameliorate levodopa toxicity except the passage of time, increased levodopa dosage slowly and gingerly. One can assume that many a PD patient never achieves maximal levodopa intervention because of this understandable concern. The PURSOR protocol permits one to increase levodopa more acutely since the administration of 5-HTP reverses the toxic symptoms of levodopa excess
C.      The neurotoxicity associated with PD and increased by levodopa administration presumptively can be reversed by the increase of 5-HT, a glutamate antagonist and a neuroprotectant with the ability to diminish excessive QUIN toxicity and cellular apoptosis associated with hyperstimulation.
D.      The PURSOR protocol, by promoting CNS 5-HT levels, should decrease or ablate the Th1>Th2 imbalances associated with autoimmune disorders and suppress or halt the underlying neurodegenerative PD process.
E.       The unprecedented and rapid partial remissions noted by patients with ALS treated with the PURSOR protocol strongly suggests that 5-HT is modulating the EAA-associated neurotoxicity endemic in neurodegenerative disorders.
F.      Approximately 15% of DA treated PD patients develop obsessive/compulsive disorders. The addition of 5-HT to the regimen potentially ablates this as a problem.
G.       PD destroys both dopaminergic and serotoninergic cells. If for no other reason, the joint administration of both 5-HT and DA precursors makes empiric sense.

(Full text) More Formal Presentation

Monday, October 19, 2009

Introduction to Immune disorders and their treatment with PURSOR


In my opinion, the neurotransmitters dopamine (DA) and serotonin (5-HT) are the primary regulators of life. These two similar substances control in a reciprocal fashion not only human beings but also all other animal species. More than two millennia ago both the Chinese and the Greeks recognized that "balance is health; imbalance is illness and pain." In summary, DA greatly resembles the Yang and 5-HT the Yin. Western medicine started to recognize this antipodal action in 1957.

Multiple articles in the current medical literature discuss imbalance in the T helper cells. T helper cells are simplistically divided into two major divisions, Th1 and Th2 cells. Harvard's Dr. Kimball summarizes this far better than I can. I would strongly recommend this link. Let's focus on the two major components.
  • The cellular immune system (Th1 driven, Th2 opposes) (increased by DA, suppressed by 5-HT) goes to work when it senses a foreign cell threatening our well-being. These foreign cells can arise from the outside, from viruses and bacteria whose survival inside our body is at the expense of our health or even our survival. This cellular system can also be activated to fight our own cells that have mutated and threaten us with cancer and similar diseases.
  • The humoral system (Th2 driven, Th1 opposes) (increased by 5-HT, suppressed by DA)   becomes activated when it senses that there are foreign proteins threatening to overwhelm us. The humoral system produce antibodies that can safely engulf these foreign chemicals and dispose of them safely.
Interestingly enough, each system controls the other. The cellular system reins in the humoral and the humoral keeps the cellular in control. Th1 suppresses Th2 and Th2 suppresses Th1

Unfortunately, when we are diseased, one or the other system can break out of control and start to overact. If the cellular system excessively dominates, doing its job too well, It starts to attack our own good cells and autoimmune diseases such as lupus, rheumatoid arthritis, psoriasis and Lyme disease ravage our bodies. In the brain, the cellular system running amok can cause neurodegenerative conditions such as Lou Gehrig/s disease or multiple sclerosis that rot our brain and spinal cord.. This is Th1 excess.

Th2 excess conditions, when the humoral system is too vigilant and the body reacts to unimportant levels of foreign protein, are allergic in nature. Asthma, allergic shock, hives and food allergies can cause us woe.Th2 excess.

By the year 2002 there had been already 200 patent applications to bring such imbalances under control. Those folks were looking to create a harmonious equality of the humoral and cellular immune systems or, in fancy terms, a Th1/Th2 balance. The treatments covered in these patent applications shared, in most cases, three qualities. They were toxic, expensive, and ineffectual.

Fortunately, It is apparent when one reads the medical literature that brain dopamine and serotonin controls the Th1/Th2 ratio and can restore it to balance.

  • Dopamine increases TH1 and controls Th2 
  • Serotonin increases Th2 and diminishes Th1. 
Why not, you may ask, don't we correct the Th1/Th2 imbalance and remit illness by increasing the brain levels of dopamine and serotonin?

The administration of the PURSOR protocol which permits our own brain to bring dopamine and serotonin into balance permits us to control either immune system that is overeager and bring us into balance. It is not surprising that when we bring the Th1 and Th2 under control that autoimmune, neurodegenerative, and allergic conditions can remit and stay away as long as the treatment is given.

Immunodeficient conditions are a bit, just a bit, more complicated. In such conditions both the cellular and humoral systems are damaged. I believe, however, with the restoration of proper dopamine and serotonin levels, these conditions  will also improve. I have seen a phenomenal success with an AIDS patient, but that is another story.

Technical section below. Click on title to get full text.

The Restoration of ImmuneTh1/Th2 Balance with Combined Dopamine and Serotonin Agonists

Pietr Hitzig, M.D. 

443 231-6240

Sunday, October 18, 2009

Combined dopamine and serotonin precursor protocol remits addictive craving & immune disorders


I have found that the contemporaneous administration of the precursors for dopamine and serotonin has widespread therapeutic applications. Using sequential suspensions of levodopa and 5-HTP when administered according to what I call the PURSOR (patent applied for) protocol, one can remit addictive craving, mood disorders and correct certain immune disorders. If interested, you can review my thoughts on PURSOR and the immune system and my thoughts on why this approach for Parkinson's disease may be most rewarding.

The PURSOR protocol employs a serendipitous finding. Both of these precursors in suspension with flavoring agents are at the onset initially pleasant. Continued administration and each suspension becomes bland to taste and then unpleasant. The loss of pleasant taste appears to correlate with repair of the inherent CNS deficiency. Incidentally, you can also produce this phenomenon at home by mixing a 0.5 tablespoon or so of MSG. (sold as Accent in the USA) with a third of a packet of an artificial sweetener. Dip a wetted finger in the powder and it is sweet. Continue to do so and it becomes salty and not pleasant. Why this happens I do not know.

PURSOR Procedure and Protocol

I leave the exact formulation for PURSOR with the formulating pharmacy in California, but this is the general idea.
  • For the 5-HTP admixture one combines powdered 5-HTP with an oil. A simple sugar syrup is added, it has an inherent pleasant taste. Other inert materials suggested by the formulating pharmacist are added. This is placed in a 30cc. bottle
  • For the levodopa, same thing. Also added is an artificial sweetener and tangerine flavoring, etc. This is placed in a 30 cc. opaque bottle and refrigerated. Levodopa oxidizes readily.
Prior to use, each bottle is shaken. 3 drops or so at a time of the 5-HTP suspension is dropped on a spoon and licked off. Back of the hand also works. Usually, this suspension is pleasant at first. Rarely, the first aliquot is mean and nasty. Continue with further aliquots until taste changes to bland. If you continue it becomes unpleasant. Should you ignore this change with either precursor, nausea and vomiting follows. The addition of a bitter substance seems to make the endpoint more noticeable.

After the 5-HTP endpoint is achieved, do the same with the levodopa suspension. The whole sequence takes about 3 minutes Were the patient craving alcohol or cocaine, severely depressed and anxious and suffering from asthma, in a moment all these disorders remit. When craving or the other conditions return, they can be effectively managed by repeating the procedure. 2-3 times a day usually suffices. The response rate for craving alcohol, methamphetamine and cocaine is nearly 100% and nearly the same for affective disorders and immediate hypersensitivity. The preliminary results with opiates is promising.

Some patients find only one suspension pleasant. I have interpreted this to mean that there is no inherent CNS deficit for this particular neurotransmitter. Control patients rarely have found both to be unpleasant from the start.

You urge the patient to swish the suspensions around in the mouth as long as possible. Since they don't spit, they swallow the residual.

Were you to immediately swallow, the respective precursors would be absorbed in the alimentary tract, pass first through the liver and be there decaboxylated to either DA or 5-HT. Absorption through the buccal and lingual mucosa permits the first pass to the brain. No need for a decarboxylase inhibitor such as carbidopa.

Addictive Craving

In 1993, I introduced Dr. Richard Rothman, director of NIDA's Intramural Research Program in Baltimore, to the idea that combined dopamine and serotonin agonists (CODAS) could treat addiction and other disorders. I have gone on and used levodopa and 5-HTP (PURSOR) as the best way to manage same. Richard has gone in another direction. In this recent article, he reviews the rationale behind CODAS and discusses his recent work.

Sample Results

Recently, in a two week period, practitioners in Colorado and Sacramento started PURSOR on seven new patients. All but one of them were craving either alcohol, cocaine or methamphetamine. All but two of them were suffering from anxiety and/or depression. In every case, the patients enjoyed total relief of craving and their mood disorders in minutes. The return of any of their symptoms (craving or dysphoria) signals the need for the next treatment. One patient is enjoying total relief from his chronic rhinitis. He is letting his stuffy nose tell him when he should take the next dose.
  • You may wish to review a brief PowerPoint Presentation).

Pietr Hitzig, M.D.
Baltimore, MD
Google Site:
443 231-6240

Sunday, October 11, 2009

Comfort from Kuhn

Why science abhors revolutionary ideas is delineated by Stephen Kuhn's The Structure of Scientific Revolutions. In this book, Kuhn created the neologism, "Paradigm shift."