On t 14 Sep, Rick Barrett wrote:
> I'm at the stage where I could use some relief
> from both the tremors and the stiffness of PD. Unfortunately, I have been
> intolerant of the medications (Pergolide and recently Paroldel). My last bout
> was yesterday. I was ramping up on Parlodel transitioning form 1.25 mg twice a
> day ( total of 2.5 mg for one week) to 3.75 mg total. About 3 hour hours
> later I felt faint - then really faint. I got very cold but was sweating
> profusely. My collegues at the office said I turned white as a sheet. I fought
> fainting for about 30 minutes then it subsided. My doc says that nausia is a
> common side effect, but this was well beyond nausia.
>
> Has anyone experienced a similar reaction? If so, were you able to overcome
> the problem by staying on the lower dosage for a longer time or some other
> method. I'm afraid that I may run out of options before I start Sinemet. My
> doc and I would like to put this off a while. I'm very interested in your
> experience.
>
> Rick Barrett (34, Dx:3yrs)
> Sunnyvale CA
> [log in to unmask]
>
Hello Rick,
I instinctively tense up when I read of people who are taking
Parlodel, because of some bad experiences which I had with it. I note that you
were initially put on Pergolide and then Parlodel (which is old-tech compared
to Pergolide). One of the main claims of Pergolide is that it has fewer side-
effects than Parlodel, although there are some people who have had the reverse
reaction. (Nothing is absolutely certain in the PD world).
Anyway, in your case you have problems with both these compounds, which are
called Dopamine Agonists; they enhance the action of Dopamine. Taken alone,
they attempt to enhance the effect of the remaining naturally-produced dopamine.
When this is not enough, the natural progression is to start on levadopa
(Sinemet).
I am aware that some experts consider it desirable to delay the introduction of
Levodopa until absolutely naecessary, in the belief that this will prolong its
effectiveness in later years. You should be aware that there is an opposing
school of thought (also supported by eminent experts) which believes that the
loss of effectiveness as time goes by is due simply to the fact that there are
progressively fewer dopamine-producing cells and dopamine receptors remaining
in the brain, and the introduction of Sinemet has no direct effect on this
process.
I tend to support the earlier introduction of levodopa, especially when you
consider the potentially major side-effects that result from the attempts to
delay the inevitable. I suggest that you discuss the options with your doctor
or neurologist. (Ask him/her to show you the list of possible effects which
can result from use of Parlodel - it makes Sinemet look like a safe bet!).
Regards,
Brian Collins <[log in to unmask]>
