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Betti Adams: I've been sensing your concern, but I hesitate to write b/c my info is not nearly as "technical" as others. Our experience has been (after 25 years of PD) that our neurologist trusts us to alter Dad's doses on our own. We monitor the effects and make the decisions. (Of course we believe ourselves to be exceptionally brilliant! JK!) About one year ago dad had hallucination problems, most severe in the evenings and then a lot of wakefulness and shouting in the night. Very stressful for Mom. There was one particular camel that kept breaking into his consciousness and biting him and galloping around the house! ( To my knowledge he never saw Ishtar) Anyway, we cut his evening sinemet in half and while he is shakier, he is lucid. Sometimes when he gets really shaky, we up it back to a whole pill for a few days, and then go back to the lower dose. It seem that with my dad, the sinemet builds up a little. Who knows, but it works for us. In addition, the neuro prescribed "Thioridazine" at night. Mom believes that this cut down on the excessive dreaming and shouting out in the night. He was actually standing on his bed one night trying to get away from that camel. "He can't walk to the bathroom, but he jumps like a monkey on his bed!" was Moms lament. I seem to remember the neuro saying that thioridazine makes the PD symptoms a little worse, and we had to be very judicious in its use. I think it has made him slower in the AM, but our family consensus is that we want mental capacity over stiffness and shakiness. Dad says the dreams are fun, but it ain't fun if Mom can't sleep. Hang in there, hopes this helps!