Exenatide

[Poss]

Has any body tried Exenatide and if so, please share dosage and results, if any.

Thanks much.

[BUSHPILOTS]

I have been on Bydureon for a month now. 2mg/wk. I have had a decrease in my main symptom, tremor. I believe this is due in part to a big drop in anxiety during this same time period which I firmly believe is a result of the drug. There is a nih article that backs up exenatide as being anxiolytic...I will post if I can find it again.

Believing it better crossed the BBB, i took two weeks of Ozempic (semaglutide) and had to stop due to the opposite reaction.

As you could guess, I am type 2 diabetic.

[pdpatient in reply to BUSHPILOTS]

Bushpilots, do you take Levodopa in any form?

[BUSHPILOTS in reply to pdpatient]

No. I dont yet. I will watch for your described issue when I cross that bridge.

[sharoncrayn]

For those who aren't familiar with Exenatide and previous trials for PD....

The Phase 2 clinical trial (2017) for the "injection" diabetes type 2 drug Exenatide showed some promise for PD patients. How much promise was somewhat debatable.

"After 48 weeks of treatment those who received exenatide were 4 points better off than those on placebo when they were assessed on a 132-point scale that measures aspects of mobility such as tremor, agility and speech.

Crucially, this difference between the two groups was still there when they were re-assessed 12 weeks after treatment had been stopped.

At this 60 week point, those who had received exenatide were on average 1 point better than at the start of the study, whereas those in the placebo group had worsened by an average of 2 points."

Sharon

[pdpatient in reply to sharoncrayn]

Sharon, your medical expertise will come in handy here. Exenatide and the family of meds work on the mechanism of delayed gastric emptying.

Hence I could never achieve proper Levodopa absorption which happens in the small intestine. Please see my response to the main thread. What do you think about the prospects of Exenatide as a viable option for people taking Levodopa?

[sharoncrayn in reply to pdpatient]

I'm a Ph.D. bio-chemist, not a medical doctor so I have no "medical" or clinical expertise with this drug.

L-Dopa absorption is a result of many factors, and it is very low to begin with. Much lower than many people think. Therefore, we have sinemet and rytary to try and enhance its effectiveness (in multiple doses) by preventing it from getting dumped into the PNS, and not the CNS.

The responses on this thread indicate to me that you do plenty of trial and error with this drug to hit its optimum effectiveness (assuming you feel using it is worth it to help your diabetes) while taking sinemet or rytary.

Find a clinician who will spend the time and trouble to work with you on this problem.

Remember, most dual purpose drugs have their limitations. You may have better luck trying a specific diabetic drug along with rytary.

Sharon

[Hidden]

I have been on it for six months at the max 2g dosage. It keeps getting better. The biggest challenge is to appropriately adjust the Levodopa dosage to account for the improvement.

Since I find it hard to convince my MDS that Bydureon/Exenatide is giving me symptomatic improvement, I am stuck with dyskinesia. My diabetes is completely under control!

You cannot get it in the USA unless you are type 2 diabetic.

[sharoncrayn in reply to Hidden]

Mal,

Correct. Approved for Type 2 Diabetics only in USA.

I am unaware of its effectiveness at controlling or diminishing identifiable dyskinesia over the long term. If this is what you are suggesting, perhaps you could elaborate. I didn't think the Phase 2 trial results suggested it could.

Sharon

[Hidden in reply to sharoncrayn]

Sharon, I am not suggesting that Exenatide helps in controlling dyskinesia. I am saying that as Exenatide gives symptomatic relief, the existing dosage of Levodopa becomes too much and hence dyskinesia. The obvious answer is that one would reduce the levodopa dosage. I think that is the adjustment that is lacking. It is something that physicians will need to consider when symptomatic treatments such as Exenatide become effective.

[Juliegrace in reply to Hidden]

If you're experiencing symptomatic relief as a result of taking exenatide, why not reduce your levodopa dosage on your own if you think it will relieve your dyskinesia?

[Hidden in reply to Juliegrace]

Point well taken. I am also inclined to experiment on my own.

[BUSHPILOTS]

It is worth noting that in the study the company Peptron altered the drug to better cross the bbb. Peptron holds the intellectual license for mass distribution of the altered formula called sustained release (SR) exenatide.

Still, it's hard for me to argue with my results with unaltered bydureon... great improvement in tremor, anxiety, and diabetes. If I get some kind of disease modification then that is the cherry on top.

[Hidden in reply to BUSHPILOTS]

I am surprised that you have experienced anxiety relief. I have not been so lucky.

[BUSHPILOTS in reply to Hidden]

Yes big time relief...sorry you are not also experiencing it. I will post summary I found talking about this.

[BUSHPILOTS in reply to Hidden]

ncbi.nlm.nih.gov/m/pubmed/2...

[Parkinsonjisung in reply to BUSHPILOTS]

Are you still taking exenatide? It's been 6months since your last post. If so what has been your experience?

[BUSHPILOTS in reply to Parkinsonjisung]

Yes. I am still taking bydureon 2mg. It is still helping with anxiety and I believe reducing tremor.

[sharoncrayn in reply to BUSHPILOTS]

Nice mouse study. It really focuses more on depression which might be common in diabetics who are also PD. Don't see a lot of relevance in this study to PwP without diabetes.

[pdpatient]

Poss, tried it for a year and reluctantly stopped it. Works extremely well for diabetes. Unfortunately, because of the mechanism of action, Exenatide (Bydureon or Byetta) interferes with RYTARY and to a large extent Sinemet. Since the action is largely unknown to doctors outside the diabetic field, my doctors never knew until we figured out what was happening and stopped.

Rytary is working much better now and as expected.