DEAR DR. DONOHUE: My husband passed away in February of this year. He just had his 67th birthday in December. He was diagnosed as having multiple system atrophy about two years ago. We had never heard of MSA. Information we got from the Internet provided all of its symptoms and a predicted longevity of seven to 10 years. He took Sinemet, medicine for Parkinson’s disease. It and other medicines did not help. He went from a healthy man to a cane, then to a walker and then to a wheelchair and finally to a hospital bed.

How prominent is this disease? Where does it originate? It’s devastating. — G.M.

ANSWER: MSA, multiple system atrophy, is a degeneration of certain brain centers from causes yet unknown. The more common variety of MSA mimics in many ways Parkinson’s disease. Patients have the muscular rigidity and stiffness of Parkinson’s disease. They’re bent forward at the waist. Speech becomes a mumble. They walk in a shuffle and are inclined to fall. Standing up brings on dizziness and fainting due to a drop in blood pressure with a change of position.

The average age of onset is 54, and longevity is predicted to be seven to 10 years. I can’t explain why your husband had such a rapid course. Perhaps it was due to your husband’s older age when he came down with it. MSA affects about three people in a population of 100,000.

The Parkinson’s disease medicine Sinemet is often tried, but no medicine has had resounding success in controlling symptoms and extending life.

You’re right. MSA is a devastating illness for the patient and for the family. You and your family have my sincerest sympathy.

DEAR DR. DONOHUE: I have suffered from major depression for most of my adult life. I have tried nearly every antidepressant and mood-stabilizer in various doses, but nothing has helped for more than several months.

I recently asked my psychiatrist if I could explore the option of electroconvulsive therapy, but he dismissed it out of hand as being something I could not afford and being a treatment that lasts for only two weeks.

Is this true? I would think the procedure would have better success rates and longer-lasting results. What are your thoughts? — B.B.

ANSWER: The doctor hasn’t come up with anything that has worked for you. I don’t understand his stance. Unless you have a physical illness that prohibits electroconvulsive (also called electroshock) therapy, you appear to be an ideal patient for such treatment. You have had no success with medicines or talk therapy. ECT gives good results that last much longer than you were told.

The two names for ECT (EST) ought to be changed; they evoke fear. In the modern form of this treatment, no observable convulsion takes place, and the process is done quickly.

The doctor gives a treatment three times a week for two to four weeks, often as an outpatient. Improvement frequently is seen after two or three treatments, more rapidly than with any other therapy. After mood has stabilized, maintenance therapy is given at intervals of one to eight weeks after the initial therapy to prevent relapses, and then less frequently. Explore this treatment with a doctor who has experience in ECT.

DEAR DR. DONOHUE: My husband and I are in our mid-80s. We have a daughter in her mid-50s, and she lives with us. She has a serious problem. She drinks 70-proof brandy, and easily can drink a pint in one night. What is she doing to her body and brain? She is a wonderful daughter. — L.K.

ANSWER: The daily limit for distilled beverages — and brandy is a distilled beverage — is 1.5 ounces of 80-proof liquor a day. Her 70-proof brandy is close to 80. She far exceeds the limit.

She places herself at high risk for liver cirrhosis. Her brain suffers if she is not taking in the suggested daily intake of vitamins. She needs the help of a professional. Start with the family doctor, or suggest Alcoholics Anonymous to her.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.

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