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February 7, 1996

The Case of the Frozen Addicts

Author Affiliations

Washington, DC

JAMA. 1996;275(5):407-408. doi:10.1001/jama.1996.03530290079047

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The Case of the Frozen Addicts is the account of an enthusiastic young doctor who parlays the wanton, antisocial, and criminal behavior of his patients into worldwide recognition as a neuroscientist.

As the narrative unfolds, Dr J. William Langston encounters several substance abusers who have been rendered immobile and speechless following use of designer drugs. His clinical observations persuade him that they are suffering from a pernicious form of Parkinson's disease. Confirmation comes when they respond to treatment with levodopa, but only with the heavy burden of side effects that limit therapy, returning them to their devastated frozen states.

Through ingenious sleuthing, Langston identifies the culpable compound as MPTP (1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine). He hypothesizes that MPTP may destroy cells in the substantia nigra, impairing the production of dopamine. His theory is proven when he replicates MPTP-induced parkinsonism in monkeys and reverses it with levodopa.

Since his patients cannot use levodopa because of

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