Brian, I started Sinement three weeks ago.  1/2 of 25/100 once a day for the
first week up to two a day in the second week and upped to three day in the
third week, and from there on a full 25/100 three times a day at meals.  I
asked if they should be taken at meals or on empty stomach and they said "it
didn't make a difference." I have been diagnosed for about two years and
tried Mirapex for about six weeks unsuccessfully.  I don't notice much
change yet but the tremors seem more pronounced and frequent.  I know you
have dealt with Sinement at length. Maybe you can fill me in with some
expectations. Thank you.  Any comments would be appreciated by anyone
experienced with Sinement.
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----- Original Message -----
From: Brian Collins <[log in to unmask]>
To: <[log in to unmask]>
Sent: Tuesday, September 14, 1999 2:54 PM
Subject: Re: BARB and CAROLE AND Requip


> On Tue 14 Sep, Clare Wilson wrote:
> > In a message dated 9/14/99 7:40:06 AM Mountain Daylight Time,
> > [log in to unmask] writes:
> >
> > <<  ReQuip, which caused severe joint and
> >  muscle pain, and a general worsening of arthritis >>
> >
> > Barb and Carole:  this is interesting.  Because I am coming down off
> > Requip to check out the possibility that it is exacerbating my
'restlessness'
> > or akathesia, whatever.  I'm going up on sinemet CR 25/l00 at the same
> > time.  During the past l8 months, my neck and shoulder stiffness/pain
> > has become more of a problem.  It sounds likely after your reports, that
> > Requip has been responsible for my own complaints, including lower
> > back and hip pain.  Brian is probably right...."don't have anything to
do
> > with the agonists!"  I'm halfway to being completely off Requip.  Wish
it
> > didn't take so long to titrate.
> >
> > Clare
> >
> >
> >
> Hello Clare; I just want to clarify your quote for others who may read
this
> correspondence and draw the wrong conclusion: I disagree strongly with
> people who are urging newly-disgnosed PWPs, or those who may only be 1 or
2
> years since diagnosis, to start taking dopamine agonists in place of
Sinemet
> /Madopar.  I slso disagree strongly with those who seem determined to
stuff
> as much as possible of any new drug down the throat of the poor PWP. Where
> is the long-term plan? (We all know that PD is progressive: so the
treatment
> should also be progressive).
>
> I do strongly agree with the use of dopamine agonists in the later stages,
> howewver, where the levodopa which we need to make up the deficiency in
our
> brain begins to be threatened by dyskinesias. It is at this point that I
> advocate the introduction of a dopamine agonist -not much - just enough
> to allow you to operate smoothly. In this way, I have kept going for the
> last 6 years, and my dosage of Permax has gone from 0 to 5 mg.
>
> Here is the breakdown of my dosage;   Diagnosed         Age 39
>                                       Started Levodopa  Age 40
>                                       Started Permax    Age 54
>                                       Current age       Age 59
>
>
> I think that any PWP, at an early stage in the illness, should be
presented
> with a forecast by his neurologist, perhaps not as aggressive as my
timings,
> but sufficient to enable the PWP to d a little forward planning in his
life.
> Regards,
>
> --
> Brian Collins  <[log in to unmask]>