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Jackie writes; >After slowly (over a 3 week period) he substituted a Mirapex (1.0) for a Permax and cutting back to 3 or 4 25/100 CRs a day, and adding one more Mirapex (for a total of 4.0 mg. per day)... Bob is not doing well at all. > >He has NO dyskinesia, but he has extreme stiffness and extreme bradykinesia. Prior to all of this he functioned pretty well, now he only has about 2 hours at three times each day where he is functional. He feels greatly pressured and very, very restless - to put it mildly (uncontrollably), he paces the floor all night and even though he is very tired he can not sleep (he has had a total of 6 hours sleep in the last four days!). I spoke to the nurse and they prescribed Amitriptyline (10 mg) for sleep. We realize this may take a few days before it will work. > Jackie and Bob, I am in my week 5 or 6 with Mirapex, I have topped out at 1.5 mgs/ day and decreased sinemet from the equivalent of (3) 25/100's per day down to about 2. I believe that Mirapex is a real strong neuro-stimulant, I feel very energetic and charged up all the time, and have had a lot more difficulty with sleep since starting it. Actually, I kind of enjoy all the energy, even though I know it's an illusion. I wonder if Bob is taking too much Mirapex and too little sinemet. I have noticed lately that even though I am moving pretty well on the lower sinemet dose, there are subtle signs of too little dopamine, such as my hands are stiff and sore, my arms ache. I know we want to drop that sinemet as low as possible, but there may be some adjustments for us all to find the happy medium. All in all I am very happy with the benefits of Mirapex, annd I hope you find your niche with it. Kathie Tollifson [log in to unmask] 47/9