MPTP

(1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine): a commercially available chemical intermediate which is also a by-product of the synthesis of MPPP (a meperidine analog) that was synthesized and self-injected by a graduate student ¹⁾, and later produced by illicit drug manufacturers to be sold as “synthetic heroin” and unwittingly injected by some IV drug abusers in northern California in 1983 ²⁾ (there is also a case report of a chemist who worked

with MPTP who developed parkinsonism) ³⁾.

MPTP was subsequently discovered to be a potent neurotoxin for dopaminergic neurons (with continued toxic effects that persisted for years ⁴⁾). As a rule, the response to levodopa is dramatic but short-lived with frequent side effects. In contrast to classic IPA, the locus coeruleus and dorsal motor vagus nucleus were essentially normal, and the symptoms differ slightly there is an as-yet unproven assertion that methylenedioxymethamphetamine (MDMA) AKA “ecstasy” (on the street), may hasten the onset of Parkinsonism (a study demonstrating a link had to be withdrawn because of a mislabeling of drugs)

¹⁾

Davis GC, Williams AC, Markey SP, et al. Chronic Parkinsonism Secondary to Intravenous Injection of Meperidine Analogues. Psychiatry Res. 1979; 1: 249–254

²⁾

Langston JW, Ballard P, Tetrud JW, et al. Chronic Parkinsonism in Humans Due to a Product of Meperidine-Analog Synthesis. Science. 1983; 219: 979–980

³⁾

Langston JW, Ballard PA,Jr. Parkinson's Disease in a Chemist Working with 1-Methyl-4-phenyl-1,2,5,6- tetrahydropyridine. N Engl J Med. 1983; 309

⁴⁾

Langston JW, Forno LS, Tetrud J, et al. Evidence of Active Nerve Cell Degeneration in the Substantia Nigra of Humans Years After 1-Methyl-4-phenyl- 1,2,3,6-tetrahydropyridine Exposure. Ann Neurol. 1999; 46:598–605