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Boy, do I have some insight! DON'T EVEN THINK OF IT! If you will read most of the fine print on PD medications, you are warned NOT to stop taking some of them abruptly. (I am thinking in particular Comtan, Stalevo,and of course Carbidopa-Levadopa (Sinemet). Doing so can result in Neuroleptic malignant syndrome (NMS), followed by possible death. NMS has also been reported in PD patients who added an SSRI to their regimen. This does NOT mean an SSRI is not to be taken - you should just be aware and recognize any problems. Before I knew better and the "drug holiday" therapy was floating around as a good idea, I decided to stop all meds to "start over" on my regimen - I even told the doctor. I have NEVER been as sick in my life! I immediately went into a manic like state and was so depressed I could barely function. I waited 3 days to contact the doctor - what a fool! Below are some specific articles on NMS - please share this info with everyone on PD meds. Peggy 1) Ward C. Neurology Care Line-127PD 2002 Holcombe Blvd., Houston, TX 77030, USA. [log in to unmask] Neuroleptic malignant syndrome (NMS) is a potentially lethal condition that has been described in patients with idiopathic Parkinson's disease (PD) after long-term dopaminergic medications are suddenly stopped or moderately decreased. If patients with PD develop severe rigidity, stupor, and hyperthermia, L-Dopa withdrawal should be suspected and the dopaminergic drug restarted as soon as possible to prevent rhabdomyolysis and renal failure. Nurses who are knowledgeable about NMS can provide prompt identification of the PD patient's condition and prevent a potentially lethal cascade of symptoms. PMID: 16001822 [PubMed - indexed for MEDLINE] 2) Hu SC, Frucht SJ. 1: Curr Treat Options Neurol. 2007 Mar;9(2):103-14 Steven J. Frucht, MD Department of Neurology, Columbia University Medical Center, 710 West 168th Street, New York, NY 10032, USA. [log in to unmask] Movement disorder emergencies occur in both hypokinetic and hyperkinetic patients. Prompt recognition of these emergencies is crucial, and diagnosis is based on history and phenomenology. Supportive and temporizing measures must be implemented immediately before disease-specific therapy is begun. For neuroleptic malignant syndrome and related conditions, we recommend a three-tier approach depending on severity, starting with benzodiazepines, dopamine agonists or levodopa, and dantrolene or electroconvulsive therapy. Methylprednisolone pulse therapy also is beneficial for neuroleptic malignant syndrome due to abrupt medication withdrawal in patients with Parkinson's disease. In treatment of other acute antidopaminergic-induced emergencies, anticholinergics usually suffice. To manage airway obstruction related to movement disorders, we rely on laryngoscopic evaluation to determine whether noninvasive or invasive interventions are needed. Hyperkinetic emergencies are treated individually based on the type of abnormal movements. If an antidopaminergic is needed, we prefer a dopamine depletor to a dopamine receptor blocker because of the risk of tardive syndromes with the latter. When focal hyperkinetic movements dominate the picture, botulinum toxin injection is a useful adjunct to medications. PMID: 17298771 [PubMed - in process] ---------------------------------------------------------------------- To sign-off Parkinsn send a message to: mailto:[log in to unmask] In the body of the message put: signoff parkinsn