Dear Kathrynne,

    Thanks for responding to my post.  Here are my answers to the questions 
and points  you posed:

RE:<<
How long have you been using the Elavil? I believe many people with PD
use Elavil quite successfully, however, there are some concerns:
>>
ELAVIL:
I have been taking Elavil since 1987.  I started it before any other PD meds. 
 (It was listed in a PD handbook.)  It was the first med I took which helped 
my symptoms.  I have taken 25 mg of Elavil until sometime in the last two 
years when it was increased.

SINEMET:(also Eldepryl)
I started Sinemet in 1988.  For a number of years I took 1/2 Sinemet 6xs/day. 
 I took Eldepryl from 1989-1991.

XANAX (also Permax, then Parlodel)
I started taking xanax in 1991 following the introduction of Permax into my 
meds.  Permax was replaced by Parlodel in 1993.


The newest drugs into my regimin are of course TASMAR and MIRAPEX.


Thanks for your good wishes.  I probably will be emailing my MDS as I don't 
have an appt scheduled.  (I saw him in August.)

Barb B-K  59/44
<<
"Tricyclic antidepressants should be used with caution in patients with
Parkinson's disease. Tricyclic antidepressants rarely can induce or
worsen extrapyramidal symptoms. In addition, involuntary movements,
which appear to be tardive dyskinesia, can occur."

Additionally, re Xanax,
"Patients who are being treated with levodopa for Parkinson's disease
can experience decreased control of the symptoms of this disease when
benzodiazepines are added to their regimen. Benzodiazepines should be
administered cautiously to such patients.

Concomitant administration of alprazolam with CNS-depressant drugs,
including opiate agonists, phenothiazines, barbiturates, ethanol,
HÀ-blockers, general anesthetics, and tricyclic antidepressants, can
potentiate the CNS effects (e.g., increased sedation or respiratory
depression) of either agent."

I imagine your MDS has been administering these cautiously, as you had
not previously reported any adverse reactions. And it may be that your
throat constriction is not related to use of either or both of these
meds. But I would bring this up when you see him tomorrow, especially as
the constriction began occurring at bedtime, about the time you take the
Elavil; and because it has gotten worse since the MDS increased the
Elavil. It's just possible that there is a relation, especially with
concomitant use of Xanax.

I hope you'll let us know how your visit goes tomorrow -- we'll be
thinking of you!!

Best regards,
Kathrynne

Barbara Blake-Krebs wrote:
>
> Hi...can anyone tell me what is likely going on here?  A problem which has
> been going on now for many, many months has gotton much worse on occasion
> recently.
> I need practice in describing it and feedback from my list cyber-family in
> preparation for contacting my MDS tomorrow.
>
> I first noticed internal rigidity in my throat at nite upon going to bed.  
It
> usually was/is relieved by morning.  Adjustments I made were to sleep with 
my
> head and torso raised.   I think my MDS increased my Elavil in response to 
my
> report of this symptom.  On a few nites it was so painful that I got up and
> played Solitaire games on my computer.
>
> Recently (about last two weeks), I have started having incidences during the
> day  whereby I feel my throat start to constrict, as it did yesterdauy
> afternoon and to a lesser degree around 11:15 a.m. today.    I find it quite
> alarming.  I think in most of these daytime incidences, it occurs after my
> usual dose of meds while they are kicking in.  But I have audible breathing
> at other times as well. (perhaps before I take meds)  Also, I have had
> incidents of worse dyskinesias.
>
> The med schedule I have been following for some time is as follows:
>
> 6:30 am  arise
> 7:00        1 xanax (0.25 mg)
> 7:30         1 mirapex (0.25)
> 8           2 Sinemets (25/100)
>             1 Tasmar (100 mg)
>
> 11 to 12:30     2 mirapex
> 11 to 1         2 sinemets
>
> 4-5     1 xanax
> 5 to 6      2 mirapexs
> 5:30 to 6:30    2 sinemets
>                 1 Tasmar
>
> 10 pm       3 Elavils 25 mg
>
>     I look forward to your input and/or questions.  Thanks.
>
> Regards,
>     Barb B-K
>        --
> Barbara Blake-Krebs [log in to unmask]

--
Kathrynne Holden, MS, RD
Medical nutrition therapy
Author: "Eat well, stay well with Parkinson's disease"
"Parkinson's disease: assessing and managing unique nutrition needs"
http://www.nutritionucanlivewith.com/
>>