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Hi David, > I was first diagnosed with Parkinson's some 20 months ago by a > neurologist in Singapore. The symptoms at that time were a slight > shaking of the right hand, difficulty in writing, stiffness in the right > arm, lack of swing and a bout of nervous shaking. The problems with my > right arm started some three years ago and were put down to computer > mouse syndrome. Looking back I can remember first symptoms some seven > years ago. PD is characterised by progressive loss of dopaminergic neurones in the substantia nigra in the brain, and hypersensitising of the dopamine receptors. The deficiency of the neurotransmitter dopamine in the basal ganglia causes poorly regulated motor control. > The first neurologist started me on Selegiline (Eldepryl) and afterwards Selegeline Hydrochloride (Eldepryl, et al) can delay Parkinsonian disability and the need for levodopa therapy by 9-12 months if given in the early stages. Later, in combination with levodopa, it can reduce levodopa requirements by 20-50%, and reduce levodopa's side effects. It may have a neuro-protective effect. One of the side-effects can be insomnia. > included Zoloft because of poor sleeping pattern. About half a year I am unaware of the effects of Zoloft, but suspect it is a short-term hypnotic. >In January this year I started on Pergolide. I have not been happy with >this drug as there were significant side effects. The worst >side-effects were a feeling of drowsiness, loss of concentration and an >impairment of the ability to focus with my eyes about one and a half Pergolide acts directly on the dopamine receptors. It is called a dopamine agonist. Its side effects can be nausea, blurred vision, and nervousness. It is given usually to mild symptoms in patients under 60 years of age, but does not have the desired effect for all patients. In patients over 60, it is usual to start levodopa first, and then to use a dopamine agonist to lessen the rate of increase of levodopa. > The medication is probably my most significant worry at the moment. I am not sure how to use it. I try 8 hour intervals to give three times a The accepted wisdom is to commence treatment with levodopa once the disease causes significant disability in daily living. Just when this occurs is different for every patient. Since PD is such a complex disorder, I can only suggest that you see a neurologist who specialises in PD as soon as possible. > Advice is a problem here. The local medical service is unwilling to give > advice or take any real responsibility. Their attitude was "only the Not just there! You seem to have the right attitude, and a couple of good reasons to persevere in seeking the right treatment for you. All the best, Jim