On Sun 16 Feb, Sue Shilinskas wrote:
> My Mom probably had a reaction to her meds today (Sinemet CR and
> Cogentin). The tremors, agitated movements of the limbs, excessive warmth
> etc. was pretty severe, but I notice that since she's fallen asleep all of
> these have stopped. This was normal for reactions to the Cogentin
> previously, but does anyone know if this is also normal for reactions to
> the Sinemet?
>
> Also the Sinemet dosage was doubled today by the doctor and she seemed to
> get less (or maybe no) benefit from the med. She's only been on it for
> three days now. Can anyone tell me what's going on?
>
> Thanks much -
>
> Sue c/g for Kathryn 85/3days
> [log in to unmask]
>
>
Hello Sue, These can be rather scary days when you begin to see some of
the effects that can occur if you get the tablet dosages wrong. I'm sure
we can sort out something better though.
First, the tremors which no doubt concerned you greatly are called
Dyskinesias, and are described as 'Random uncoordinated movements of the
limbs. They are quite different to the normal Parkinson's tremor, and are
in fact caused by too MUCH Sinemet.
I have now seen your response to Jack Savely, and this story is beginning
to look more and more like a classic case of How Wrong Can you Be !! Not
you Sue, I hasten to add, it is your doctor who needs a large boot ,
applied in the appropriate place! It seems to me that he is trying to
educate himself by using your mother as a guinea pig to test the effects of
various tablets.To arbitrarily double the intake of a powerful drug like
Sinemet is irresponsible. When any changes are made they should be carefully
planned and introduced.
The use of Cogentin also surprises me: It is one of a bunch of drugs which
were used before levodopa came along, because they had nothing better. They
are called anti-cholinergics, and are NOT advised for elderly patients, as
they can cause confusion. There are much better options available these
days. I wonder when your doctor last prescribed for a Parkinson's sufferer?
It is quite normal for a PWP to sleep absolutely motionless, even though
they were going through wild gyrations when they were awake! I do it
myself. The bad news is that you tend to wake up feeling stiff and
uncomfortable from lying in the same position for several hours. I'm
afraid that is another PD effect which she will have to cope with. ( A
half-strength dose of Sinemet taken just before going to bed can help her
sleep, and should promote more normal sleep.
The best advice that I can give you, is to try and have your mother examined
by a neurologist specialising in Parkinson's or Movement Disorders. If this
is not possible, then I would advise that you check any changes proposed
by your doctor, with the old hands on this list.
Regards,
--
Brian Collins <[log in to unmask]>
