Supermario:
Thanks for the report, and without having any disrespect to Dr. D.
Hobson, a MDS neurologist who is considered to be among one of the
most respected MDS neurologists in North America this Media report on
the research paper becomes very controversial.
I have to ask these why's.
1. Why did I not have any sleep attacks daily prior to using either
Requip and/or Mirapex?
2. Why do I not have any sleep attacks since, for over a year, after
having discontinued their use?
3. Why did my neurologist request that I turn over/in my driver's
license to him when I reported my sleep attacks?
4. Why was my medication changed IMMEDIATELY THAT DAY to seligilene
without any titration (normally 8 weeks)off Mirapex when I refused to
turn my license in?
5. Were the Epworth Sleepiness Scale and Sleep Composite Score, the
appropriate tools to effectively measure these sleep attacks?
6. If I knew I was going to lose my license and my ability to earn a
living ( self employment) for me and my family and have to drive
daily- would anyone placed in this position- want to correctly report
those attacks?( I did). Further If someone knows prior to reporting,
what the dire consequences will be, of reporting the frequency of
sleep attacks would they, in being of human in nature, want to reduce
that reporting frequency?
7. If I had killed someone, while driving, especially a family member
during one of my sleep attacks, while driving, could I have lived with
that for the rest of my life? NOT LIKELY!
Does anyone really want the stress of mind and nightmare, after tossin
my cookies and in a cold sweat, stopped on the shoulder of the
highway, less than 300 yards behind me, where I had a sleep attack and
drove alongside a walking crowd ( at speed of 36mph/60 kph) of 10-20
children,women, and men-- REALIZING then that, had I, drifted to the
right during my sleep attack that I could have killed ALL or SOME of
them?? I know, many fellow parkies, that I have personally talked to,
who are using either drug, and are having or had these same sleep
attacks and who are driving.
After reading this posting I am both shocked and surprised at the way
the Media reported results of this research paper. If the Media is
helping the Drug Company in flogging these drugs through distortion of
the facts , then it is a sad time for all of us who are suffering and
losing our quality of life because of their specific use.
It is my personal statement that the following report of the Media on
this research paper on these two drugs does not reflect my personal
experience.
Don
PD 53/4
On Saturday, February 2, 2002, at 09:32 AM, supermario wrote:
Arial0000,0000,9994Parkinson's
Drugs Don't Cause Sudden Sleep
Arial
Arial
Arial
Helvetica0000,0000,0000(HealthScoutNews)
-- Debunking previous research, a new study finds no connection
between medications people with Parkinson's disease take and their
sudden bouts of sleepiness while driving.
The finding is especially important in Canada, because that government
has required warning letters about pramipexole (Mirapex) and
ropinirole (Requip), based on studies suggesting they promote
sleepiness, says Dr. Douglas E. Hobson, lead author and an assistant
professor of neurology at the University of Manitoba.
"When the Canadian government requested the warning letters on these
two drugs, it said the warning was pending further information,"
Hobson says. "This is further information."
The U.S. Food and Drug Administration has not issued a similar
warning, but many doctors here have been cautious about prescribing
the drugs.
Excessive daytime sleepiness is known to be common among patients with
Parkinson's disease, in which a deficit of the brain chemical dopamine
can cause trembling, stiffness, difficulty walking, and reduced mental
function. The two drugs, which promote dopamine activity, have been
reported to cause sudden sleepiness while driving.
But a study of 638 patients at 18 Canadian clinics found no such
connection, says a report in tomorrow's issue of the Journal of the
American Medical Association.
The researchers used the Epworth Sleepiness Scale and an Inappropriate
Sleep Composite Score, specifically developed for the study, to
determine not only the risk of falling asleep, but also how often it
occurs.
They found 51 percent of the patients reported daytime sleepiness, and
the number of times that happened was not affected by any medication
the patients were taking. They also found the risk of the much-feared
sudden onset of sleep while driving is rare. Only 16 patients reported
a sudden onset of sleep while driving, and only 3 said it occurred
without warning.
The score on the two tests, taken together, "is a useful tool to
identify patients who are abnormally sleepy, and may play a role in
increasing patient and physician awareness of this significant
clinical problem," the journal report says.
"We were looking for predictors, because everyone was told they
shouldn't drive," Hobson says. "This will be helpful in selecting out
the patients who shouldn't be driving."
The study is also useful because it gives solid information about
unwanted sleepiness, he says.
"No one knew how often it happens," Hobson says. "Knowing the
frequency will help a lot in relation to regulations about driving."
The study will help doctors treating Parkinson patients because it
gives them a way of identifying patients at high risk of unwanted
sleepiness, says Dr. Cynthia L. Comella, of Rush-Presbyterian-St
Luke's Medical Center in Chicago.
"The most important point of the study is the ability to measure
sleepiness in Parkinson's disease," says Comella, who wrote an
accompanying editorial. "The method is quite simple and clinically
applicable. Until now, nothing has been shown to assess sleepiness in
correlation with driving."
