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Norm, My personal experience with each of the 3 agonists you mentioned was that none were totally effective in eliminating Parkinson's symptoms(mine are rigidity, slowness, balance problems NO tremor). The pergolide gave me very bad stomach upset/reflux, the mirapex made me sleepy , the requip used WITH sinemetCR is the best combination for me. Your mother should not give up. Finding the right drug combination can make her feel alot better. It is important to titrate to correct level and this level is DIFFERENT for everyone. I only take a daily total of 3mg REQUIP w/levodopa/cardopa in the SinemetCR and that allows me to function pretty well. My MDS is learning that my body doesn't allows need as much of a drug as the drug co. recommends. You and your mom have come to a great place for personal opinions of pwp. Of course, find a neuro who willwork with her is important for your mom. Jeanette Fuhr 50/47/44? ---------- From: Norm Leonard <[log in to unmask]> To: [log in to unmask] Subject: Bad reactions ??? Date: Tuesday, November 07, 2000 11:47 AM I'm here to ask the expertise of this learned on-line community. My dear mother is a regular "visitor" here for some three years, diagnosed with PD approx. five years ago. The onset of what I now understand is classic PD showed up as a slight tremor in her right hand, and was first noted in her writing (as a teacher). By the time of her diagnosis, it had progressed to the obvious tremor and "cogwheel" effect on the right arm and the associated back pain. A short run with Artane proved too much and she stopped after five days, chosing to deal with the tremor instead. She elected to stay away from the meds until last year (by now PD was affecting the right side, walking balance, and chin/tongue) and started on Requip. Even at near maximum level, no appreciable reduction in arm tremor was acheived (though chin and balance had improved somewhat...), and she was switched to Mirapex (weaned off the old and onto the new, per her PD specialist). Following her last consult with her Winnipeg PD doc and loss of effectiveness of the Mirapex, as of two weeks ago she's made the transition (possibly too fast?) to Pergolide. This new med (Permax) has been the worst so far. At the doctors recommended dosage, it's completely knocked her off her game. Listlessness, back pain, weakness in her legs... I'm worried enough now about the effect on her morale: If she's unable to sleep and "recharge" from the effort of the tremor, there's no telling where we'll be in a week. My question(s): Does anyone recognize this progression in use of the PD meds or does this approach sound at all unusual? Is Permax typically slow to "kick in" and and start seeing results with? Finally, I have seen much reference to the application of Sinemet either early/late in treatment of PD or in combination with other meds. Is their a reason they'd commonly hold this med in "reserve" in a case like this? Your thoughts and input would be much appreciated. My apologies for running so long with this, and thanks very much in advance. Norm Leonard Kenora, ONT. [log in to unmask]