Requip and any of the agonists are capable of causing dyskinesias.  The only claim that has been made is that they cause less dyskinesia than levodopa, NOT no dyskinesia.
 
Cutting the CR tablet in half causes only PARTIAL loss of the CR quality of Sinemet CR, but not a total loss.  Indeed, many neurologists use 1/2 of the 50/200 CR tablet with great success, just being careful to titrate for effect.  It is less expensive for the patient to prescribe it that way than to prescribe the CR 25/100.
 
The fact that your friend was dyskinetic all day despite taking only a single half tablet of Sinemet CR in the AM would, in my mind, prove that the cause of the dyskinesia was indeed the Requip.  If the dyskinesias are so severe, then a downward adjustment in the Requip may be of benefit.  If that is not possible because of loss of efficacy, then she might be a candidate for surgery, such as the implantation of the deep brain stimulator.
 
Her neurologist should be able to answer these questions for her.
 
 
Jorge Romero, MD  
----- Original Message -----
From: [log in to unmask] href="mailto:[log in to unmask]">Sandra Norris
To: [log in to unmask] href="mailto:[log in to unmask]">[log in to unmask]
Sent: Thursday, October 12, 2000 1:01 AM
Subject: SOME HELP PLEASE!

Hello List Family,
 
I have a friend with Pd that has suffered with dyskinesias off and on since 8:00 am.  I just got off the phone with her.  She has had only two non-dyskinetic hours today.  Here are her stats...She has been diagnosed for 4 years, symptomatic for 1 1/2 to 2 yrs before dx.  She is on Sinemet CR 50/200 . She takes 1/2 tablet to get her started in the morning.  The only other med she is on is Requip.  She takes the sinemet morning and early afternoon.  But today she has only had the morning 1/2 tablet...not sure about how much requip she has had..maybe 2 doses..or 3. 
 
My question is...Is it recommended to cut a CR tablet in half?  Would this not effect the time-release capability of the CR?  Can requip cause Dyskinesia?  I know that in early-onset and early detection only agonists are used in order to maximize the dopamine still being produced by the brain.  My heart is going out to my friend.  I told her I would be posing this to the list..Any opinions, suggestions and Rph input would be very much appreciated.
 
 
Sandy Norris 40/28/20
"Faith is the daring of the soul to go farther than it can see."