Healthcare Technology Featured Article

February 18, 2020

Understanding Dyskinesia by Sahm Adrangi of Kerrisdale Capital

If you or someone you know has been diagnosed with Parkinson’s disease, there is a good chance that they will receive the standard combination of the drugs levodopa and carbidopa. The treatment is especially helpful for symptoms of Parkinson’s, including muscle stiffness, tremor, and slow movement. On the other hand, the combination has been known to induce a common side effect known as dyskinesia, which could make tremor-like symptoms worse.

I am Sahm Adrangi of Kerrisdale Capital Management. Kerrisdale Capital focuses its efforts on short activism by conducting and publishing reports on a variety of industries, including the health and pharmaceutical sector. In this article, I will discuss what dyskinesia is, what causes dyskinesia, and potential options for Parkinson’s patients living with dyskinesia. I am Sahm Adrangi, and I am the founder and CIO of Kerrisdale Capital.

What is dyskinesia?

Dyskinesia is identified by rapid, uncontrollable, and involuntary movements that mimic the very symptoms typical of Parkinson’s disease. The condition may cause writhing, swaying, twisting, flailing, squirming, or head bobbing. Dyskinesia may occur on the side of the body that is diagnosed with Parkinson’s, or it may be localized to a specific part of the body such as the arms, legs, torso, head, or neck. In more rare circumstances, the condition may affect speech as well as eye and respiratory muscles.

What causes dyskinesia?

Dyskinesia is a common side effect of drugs used to treat Parkinson’s disease. Parkinson’s patients experience a loss of dopamine neurons which cause a decrease in dopamine levels. While Parkinson’s treatment is supposed to restore dopamine levels, it is taken intermittently throughout the day, creating a rise and fall. This fluctuation is thought to cause symptoms of dyskinesia which range from mild and not so bothersome to reasonably debilitating.

Dyskinesia is more common for those who undergo long-term treatment for Parkinson’s and doesn’t typically emerge until 4 to 10 years from the start of treatment. This makes those who need treatment at a younger age at a higher risk. Once dyskinesia begins, it may be challenging to treat. When other methods have not worked, the most severe cases may undergo deep brain stimulation surgical methods.

Are there other options for Parkinson’s patients?

At present, this is the most effective way to relieve the severe and long-term effects of Parkinson’s, including stiffness, tremor, and slow movement. Those in the earlier stages of the disease may have other options available to them. Others with milder symptoms that have not yet formed dyskinesia may be able to begin a dopamine receptor agonists, but will eventually need to transition other standard treatments.

Thankfully, there may be relief from the dyskinesia with a variety of existing and new drugs on the market. Once dyskinesia has begun to interfere with your life, patients may be prescribed extended-release formulations and continuous intestinal infusions to reduce dopamine fluctuations. New drugs that contain high levels of amantadine have also been found to be particularly useful in lowering dyskinesia and additionally help with Parkinson’s symptoms.

Sahm Adrangi Thoughts and Conclusions

The development of new, more effective drugs is an essential aspect of pharmaceuticals with the potential to help millions of people worldwide. I am Sahm Adrangi, and at Kerrisdale Capital, we take a close look at the potential success and failure of pharmaceutical companies that are developing new products. Myself Sahm Adrangi and Kerrisdale Capital then publish reports on the research that we find, to inform others on topics that may be misunderstood in the market.

About Sahm Adrangi

Sahm Adrangi founded Kerrisdale Capital Management in 2009. He is well-known for his work in short-activism and his effort in educating the public on misconceptions in the market. In addition to publishing research, Mr. Adrangi has taken an activist role in investments. Mr. Adrangi has spoken at numerous conferences and has been featured in major publications including the Wall Street Journal, the New York Times, the Washington Post, and BusinessWeek.

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