Boy, do I have some insight!  DON'T EVEN THINK OF IT!  If you will read most
of the fine print on PD medications, you are warned NOT to stop taking some
of them abruptly.  (I am thinking in particular Comtan, Stalevo,and of
course Carbidopa-Levadopa (Sinemet). Doing so can result in Neuroleptic
malignant syndrome (NMS), followed by possible death. NMS has also been
reported in PD patients who added an SSRI to their regimen.  This does NOT
mean an SSRI is not to be taken - you should just be aware and recognize any
problems.

Before I knew better and the "drug holiday" therapy was floating around as a
good idea, I decided to stop all meds to "start over" on my regimen - I even
told the doctor.  I have NEVER been as sick in my life!  I immediately went
into a manic like state and was so depressed I could barely function. I
waited 3 days to contact the doctor - what a fool!

Below are some specific articles on NMS - please share this info with
everyone on PD meds.
Peggy

1)   Ward C.
Neurology Care Line-127PD 2002 Holcombe Blvd., Houston, TX 77030, USA.
[log in to unmask]

Neuroleptic malignant syndrome (NMS) is a potentially lethal condition that
has been described in patients with idiopathic Parkinson's disease (PD)
after long-term dopaminergic medications are suddenly stopped or moderately
decreased. If patients with PD develop severe rigidity, stupor, and
hyperthermia, L-Dopa withdrawal should be suspected and the dopaminergic
drug restarted as soon as possible to prevent rhabdomyolysis and renal
failure. Nurses who are knowledgeable about NMS can provide prompt
identification of the PD patient's condition and prevent a potentially
lethal cascade of symptoms.
PMID: 16001822 [PubMed - indexed for MEDLINE]

2)  Hu SC, Frucht SJ.  1: Curr Treat Options Neurol. 2007 Mar;9(2):103-14
Steven J. Frucht, MD Department of Neurology, Columbia University Medical
Center, 710 West 168th Street, New York, NY 10032, USA. [log in to unmask]

Movement disorder emergencies occur in both hypokinetic and hyperkinetic
patients. Prompt recognition of these emergencies is crucial, and diagnosis
is based on history and phenomenology. Supportive and temporizing measures
must be implemented immediately before disease-specific therapy is begun.
For neuroleptic malignant syndrome and related conditions, we recommend a
three-tier approach depending on severity, starting with benzodiazepines,
dopamine agonists or levodopa, and dantrolene or electroconvulsive therapy.
Methylprednisolone pulse therapy also is beneficial for neuroleptic
malignant syndrome due to abrupt medication withdrawal in patients with
Parkinson's disease. In treatment of other acute antidopaminergic-induced
emergencies, anticholinergics usually suffice. To manage airway obstruction
related to movement disorders, we rely on laryngoscopic evaluation to
determine whether noninvasive or invasive interventions are needed.
Hyperkinetic emergencies are treated individually based on the type of
abnormal movements. If an antidopaminergic is needed, we prefer a dopamine
depletor to a dopamine receptor blocker because of the risk of tardive
syndromes with the latter. When focal hyperkinetic movements dominate the
picture, botulinum toxin injection is a useful adjunct to medications.
PMID: 17298771 [PubMed - in process]

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