There has been much discussion both on this list and among neurologists
about when to introduce levodopa, especially is the patient is under 50-55.
 Some neuros seem to take the delay levodopa plan and try agonists and
other drugs alone. In some pwp, this therapy gives sufficient relief of pd
symptoms. In other pwp, the introduction of levodopa alone or with
agonists, segeline or other meds is more helpful in controlling pd
symptoms.

Ask your neuro why he wants to try Mirapex another 4 weeks? Is it because
he thinks an increase in the daily dose may be needed to obtain theraputic
dosage? Have you tried keeping a drug/symptom diary? This is a daily log
that shows time of dose, time of meals(& type of food), and the pd symptoms
as the day progresses. This can be very helpful to detect if the drugs are
working or causing side effects, and can help show problems relating to
timing of food intake and meds.

Being proactive and by that I mean learning all you can about pd, pd meds
and therapies is important for pwp. You must be sure you are doing an
excellent job communicating your symptoms and your concerns to the nurse
and to the neurologist. I try to not ever accuse the dr. of an error,
choosing instead to indicate my disappointment that what has not seemed to
work must be reexamined and a diff solution be tried. I also make a point
of writing my ?? on paper with a copy for the nurse, one for the neuro and
one for me to take notes as to the answers. In that note, I always thank
the nurse, the doc and the university for the concern and help they
demonstrate for me and my needs.

As to giving up Mirapex, your neuro should know if he/she wants to try a
diff agonist or if adding levodopa with the Mirapex is the plan that may
help you function best and control the pd symptoms. Normally titrating
slowly up and down is the plan I follow with my neuro's approval.

Yes, PD meds are confusing and having a chronic illness can be depressing.
BUT.......you have this group to help with the confusion and we even can
lighten the day with a story or a joke on occasion or offlist.

Good luck,

Jeanette 49/47/44?

----------
From: Sherry Macredes <[log in to unmask]>
To: [log in to unmask]
Subject: Question on Mirapex
Date: Monday, November 29, 1999 12:20 PM

Dear Experts..

I am new to PD and need more info on meds to keep my neuro on his toes! I
have been using Mirapex alone since dx in early Aug. After a long battle
of
increases I am now up to 4.5MG per day with no positive results. Now my
neuro wants to keep me at this level for the next four weeks to be sure
there
is no improvement before trying something else. After reading the posts on
the list over the last few weeks, it seems strange to me. How can I be
sure
it's really PD? Shouldn't I have been given some sinemet to see if I
improved to be sure of dx? Don't most people need more than one
medication,
should I give up on Mirapex before adding something to it? It's all very
confusing....not to mention depressing. Thanks for your input,


Sherry
49/48/43