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    Three years ago I received some of the best news of my life — that I have dopa-responsive dystonia. (Yes, a neuromuscular disorder was welcome news.) Painful, life-interrupting muscle contractions had made the dystonia diagnosis likely several years before, despite poor response to standard treatments, and I was fighting through graduate school: trying to compensate for medication-induced memory problems, increasing need to work from bed, and a disappearing social life. A visit to Mayo ended with the correct suggestion that I might respond to levodopa. In fact, I am among a small, perhaps 3 percent, group of dystonia patients whose symptoms almost disappear with it (and thus, am “dopa-responsive”). Unfortunately, I’m also a patient who vomits uncontrollably on levodopa. (Levodopa, which the body converts to dopamine, causes nausea when converted before reaching the brain, where I need it to control my muscles.) Despite careful titration and three other anti-nausea medications, I repeatedly needed IV fluids and was miserably nauseated until a “miraculous” solution: domperidone. As a dopamine antagonist, domperidone fights the nausea; because in adults it mostly doesn’t reach the brain, it uniquely doesn’t affect the therapeutic reason for levodopa. With domperidone and levodopa, I’m a happy “normal” academic with an appropriately nerdy social life. Murray Shore Pharmacy will not ship domperidone without a prescription from an MD licensed to practice in the province of Ontario. The physician does not need to be practicing in the province of Ontario.

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