Hello Charlie.  I'm interested in your discussion on Mirapex.  I gather if
you have been taking Mirapex since it came out, I would guess you have been
taking it about two years.  Were there any beneficial effects during that
period?  I have been taking Mirapex for about 2 1/2 months now and don't
notice any good effects looking for it to relieve the tremor and fatigue.I
am in the midst of trying to make a decision of whether to quit Mirapex.  I
known I should look to my doctor's decision but I always entertain real
experiences.  Thank you,

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-----Original Message-----
From: Charles T. Meyer, M.D. <[log in to unmask]>
To: [log in to unmask] <[log in to unmask]>
Date: Friday, March 12, 1999 7:28 AM
Subject: Re: Switching meds--info please?


>HI Ann,
>I  can comment more as a patient than as a physician.  Regarding the
>switch from Mirapex to Requip,  I started Mirapex changing from Parlodel
>during a hospitalization when Mirapex was first released.  My Neurologist
>switched me calculating the equivalent dose of Mirapex rather than disable
>me (even more) by phasing one down while increasing the other.  The Requip
>was started after the Mirapex had reached beyond maximum dose without
>substantial (increased) benefit. The requip was better (for me).  The
>switch was while I was at home and was a sudden change giving me again
>equivalent doses of Requip to the Mirapex.  As time has progressed either
>the Requip has lost its effectiveness or my PD has gotten worse
>(unfortunately I think it is the latter).  I currently am taking above the
>recommended dose and after getting lab work I likely will be increasing
>even more.   If you can put off the Sinemet that would make sense to me-
>however if the Requip doesn't give you substantial reduction of symptoms-
>to a level where your life can proceed reasonably normally-  I would not
>hesitate to add the sinemet. Sinemet can give a response in a few days but
>is usually titrated up slowly to give optimum effect.
>
>Good luck,
>
>Charlie
>
>serenityplus wrote:
>
>> Hi,
>>
>> I've been in the TEMPO study, which is a drug study for an MAO type B
>> inhibitor, much like Selegiline. I've been on open label with the dose
>> still blinded; also, I'm taking Mirapex, barely 1.5 mg/day (had some
>> dose limiting side effects, like sleepiness, but no orthostatic
>> hypotension.  I've haven't gotten a good response to Mirapex, and I
>> feel, much as I would like to put off Sinemet (I'm 54, diag. a year
>> ago, probably had it from about '89) that my symptoms are really
>> getting in my way:  tremor is essential, not resting, so it's not a
>> problem, but the inability to do much with my right hand, and dragging
>> my right side is getting to be too much.
>>
>> I'm concerned that trying another agonist like Requip will take
>> forever (My titration experience with Mirapex was VERY LONG) and may
>> not do any more, and may cause problems for nothing.  I've read that
>> it takes weeks or even months to get an adequate response from
>> agonists.  I've taken Mirapex, albeit in small increasing doses, since
>> last Sept. and it hasn't done much. I suppose the PD could be
>> outpacing the therapy also.  Q:  Does Sinemet take long to show a
>> response?  How tough is it to come off Mirapex (though maybe I
>> shouldn't).  Any strategies coming to mind on handling starting
>> generic carbadopa/levodopa with/without Mirapex?
>>
>> I would be grateful for any response.  Thanks!
>>
>> Ann
>
>--
>***************************************************************************
***************
>
>Charles T. Meyer,  M.D.
>Middleton (Madison), Wisconsin
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>***************************************************************************
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