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Sharon, There are about as many opinions on this as there are people on the list. Here's mine. The agonists- Requip(ropinerol) and Mirapex (pramipexole) are helpful in slowing the need to take Sinemet which for many PWP is the cause of dyskinesias- uncontrolled random movements that can occur 2-4 years after the start of Sinemet. It is theoretically useful to start it late and at the lowest possible dose. The agonists can aid in that process. Practically it makes sense to try an agonist alone first and see if there is acceptable symptom relief. If not start or add Sinemet keeping the dose as low and even through the day as possible. Some people are adamant that agonists are a waste of time and one should start Sinemet as soon as it is needed. My position is that while some of the studies related to the agonists may be flawed it does make sense to try them first. But don't try so hard to avoid Sinemet that the withholding of the Sinemet allows significant disability to exist from the PD, which may have been avoided by taking the drug. Progress is being made in PD research so rapidly that possibly he will not have to face the dyskinesia at all or he may be treated for it. For example; DBS is useful for dyskinesia and wasn't available 5-6 years ago. Regarding side effects of the 2 agonists, most people do not have severe side effects. I took each and neither gave me significant problems although they can cause various difficulties (as can Sinemet) in certain individuals. I can provide you with the package insert info, if you desire, detailing all of them. But the side effects are an individual thing and the way I would do it is to start on a very low dose and increase as tolerated. BTW I am a 56 year old retired psychiatrist with Parkinson's not a neurologist so please take my advise accordingly and just as opinion. I suggest your father be seen, at least in consultation, by a Movement Disorders Specialist (a neurologist with sub-specialization in PD)in his locale prior to starting anything and get the advice of an expert in the field. Treatments are changing so rapidly that this is advisable. Charlie ----- Original Message ----- From: "Sharon Nelson" <[log in to unmask]> To: <[log in to unmask]> Sent: Wednesday, May 24, 2000 9:44 AM Subject: Some Newby Questions > My Dad has been diagnosed with Parkinson's. Right now he has a tremor in > his right arm and is experiencing some of the other early symptoms like a > shuffle in his gait and a slight difficulty speaking clearly. > > He has not begun any medication yet. Mom and Dad have heard about some of > the side effects and are hesitant to take the first step. > > I have read that some of the drugs like Equip and Mirapex can help early > symptoms alot--maybe for 5 to 10 years. Could someone help me to know > about these two drugs and their side effects anyone has experienced. > > In your experience do the benefits outweigh the side effects.? > > Thanks so much for your input. > Sharon Nelson > Columbia, MO 65201 > Phone: 573-884-4074 >