Jackie writes;


>After slowly (over a 3 week period) he substituted a Mirapex (1.0) for a
Permax and cutting back to 3 or 4  25/100 CRs a day, and adding one more
Mirapex (for a total of 4.0 mg. per day)...  Bob is not doing well at all.
>
>He has NO dyskinesia, but he has extreme stiffness and extreme
bradykinesia.  Prior to all of this he functioned pretty well, now he only
has about 2 hours at three times each day where he is functional.  He feels
greatly pressured and very, very restless - to put it mildly
(uncontrollably), he paces the floor all night and even though he is very
tired he can not sleep (he has had a total of 6 hours sleep in the last four
days!).  I spoke to the nurse and they prescribed Amitriptyline (10 mg) for
sleep.  We realize this may take a few days before it will work.
>

Jackie and Bob,

I am in my week 5 or 6 with Mirapex, I have topped out at 1.5 mgs/ day and
decreased sinemet from the equivalent of (3) 25/100's per day down to about
2. I believe that Mirapex is a real strong neuro-stimulant, I feel very
energetic and charged up all the time, and have had a lot more difficulty
with sleep since starting it. Actually, I kind of enjoy all the energy, even
though I know it's an illusion.

I wonder if Bob is taking too much Mirapex and too little sinemet. I  have
noticed lately that even though I am moving pretty well on the lower sinemet
dose, there are subtle signs of too little dopamine, such as my hands are
stiff and sore, my arms ache. I know we want to drop that sinemet as low as
possible, but there may be some adjustments for us all to find the happy medium.

All in all I am very happy with the benefits of Mirapex, annd I hope you
find your niche with it.

Kathie Tollifson
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