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 -----
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."