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On Tue 01 Jul, David Havard wrote: > Brian, > > you said "drugs" in plural. Do you have any advice for Pergolide on its > own? > Would be grateful if you did. > > I almost missed this question- sorry about the delay. I have personal experience of Pergolide; I currently take 10 x 250 micro gram tablets of Pergolide ( i.e. 2.5 mg). When I was taking a smaller quantity of Pergolide, I did some sums to see if I could replace the levodopa with Pergolide. (At that time, the recommended max dosage of Pergolide was 3 mg ) I concluded that to replace all of the Dopamine would require much more than the 3.0 mg max limit. With further satisfactory experience, I gather that today's max recommended limit is up from 3mg to 4mg. but even this is not really enough to replace levodopa. As to the logic of replacing the entire intake of levodopa with Pergolide, I do not consider it to be a good thing to do: levodopa (when converted into Dopamine) is the same chemically as the dopamine missing from the brain of a PWP. The Dopamine agonists are tailored to fit into the Dopamine receptors, but otherwise they are not the same as dopamine. I would be worried that there may be other subtle interactions which the agonist may not support. I have noted that when used in conjunction with levodopa, Pergolide seems to 'soften' the otherwise rather harsh, transition from 'off' to 'on' and vice versa. ( By harsh, I mean that sometimes I found adjacent muscles fighting each other during the transition - an extremely painful condition. Because of its relatively mild effect, I have found that the best way to use Pergolide is to set up a system where you are taking X gm of levodopa (Whatever you need) and 500 micro grammes of Pergolide. From this baseline, as you proceed downhill (as we all do ) you can just add a couple more Pergolide to your daily intake, to counter the deterioration. In this way, I have worked my way from 2 x 250ug to 10 x 250 ug per day, which gives a clear measure of my personal rate of descent. The exchange rate of Pergolide v levodopa, as it affected me, and based on the first 1 mg of Pergolide (it may not be linear at higher dosages) is that 1 mg per day of Pergolide can replace 17 mg per hour. Note that I use units mg per day for Pergolide and mg per hour for levodopa.) To express that in a more easily understandable way, taking 4 x 250 micro grammes of Pergolide would enable you to reduce your intake of levodopa from say 900 mg per day to about 700 mg per day. ( It is necessary to back-off the levodopa otherwise over-dosing will result.) Also, whatever the hype about D1 D2 receptors is, I found that there was NO improvement in overall 'headroom'. That is to say that the window which I am aiming for is still the same size as before. Nevertheless, agonists are on balance worth having in moderation. I wrote more than I intended, but I hope at least some of it may be useful. Regards, -- Brian Collins <[log in to unmask]>