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Hi Bob:

I would follow the advice of your neurologist.  In addition to comnsidering an increase in the
Sinemet dose, or using Requip, you might also inquire about using Pergolide (Permax).  Although no
formal studies have been done, Pergolide does not seem to have the same propensity for causing sleep
attacks as Requip and Mirapex.

Jorge Romero

----- Original Message -----
From: Bob Chapman <[log in to unmask]>
To: <[log in to unmask]>
Sent: Wednesday, February 09, 2000 11:54 AM
Subject: Mirapex, Requip, Comtran Advice neded


> I need some advice from anyone who may have had similar experience with
> the following:
> I was taking Mirapex (1.5 mg per day) titrated from .375 mg per day over
> 8-9 months. I developed swollen ankles and "sleep attacks" the next 2-3
> months. I tried relafin for swollen ankle, didn't work. Dr. then put
> ankle in a cast for a month, that didn't work either. I read on the list
> where some were having similar problems be cause of Mirapex. I stopped
> Mirapex (slowly) and swollen ankles and sleep attacks were gone, 4-5
> months ago. Neuro thinks I am now under medicated because of increased
> tremors, slower gait, minor balance problems and increased drooling. He
> says I have two options, add requip to meds or add straight Sinemet and
> increase Sinemet CR ( I now take 21/2 tabs per day, 50/200 Sinemet CR)
> That's my only sinemet med
> I am afraid Requip will have the same side effect of swollen ankles and
> "Sleep Attacks" as Mirapex did.
> What would you do?
> Bob Chapman 66/60/55
>