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On Sun 05 Oct, Liisa Millen wrote: > Brian and others, thanks for responding. I have been taking SinemetCR > 50/200 3x, so I guess my carbidopa has been close to the recommended range. > I am now up to 1.5mg Mirapex, and have reduced SinemetCR by 1/2, getting > 75mg of Carbidopa and 300mg of Sinemet per day. Now the problem is where to > go from here, I was instructed to increase Mirapex further, but after > reading the possible side effects I am wondering which is worse, Sinemet or > Mirapex. I understand dopamine agonists are believed to have some > neuroprotective qualities, but there so many thing that scientist disagree > on. My level of functioning is adequate now, I have occasional short "off" > times, and sometimes mild dyskinesias at peak dose. > > I found Madopar in my drug book as a combination with benserazide, 200/50 > and 100/25. > > Thanks again, Lisa > > [log in to unmask] > > > Hello Lisa, you appear to be coping well at the moment (How many years is it since you were diagnosed? My guess would be about 6 years? I have no experience of Mirapex, so cannot offer any first-hand experience. You might consider this, however: You (I think) are at a relatively early stage in the disease, are using a very modest amount of levodopa, and I see no reason for you to take on the challenge of a new drug. I don't mean to sound callous, but there are other people out there whose quality of life is not good, who are happy to blaze a trail with a new drug. I have not seen any of the recent flood of new drugs actually fail to achieve its primary role, but I have observed ( and experienced) side effects which are definitely to be avoided if at all possible. The problem is that 'one man's meat is another man's poison' as they say, and the only way to find out is by trial and error. So take the easy route, try the established drugs first (I would suggest Permax as an agonist). Your turn to take a bold step will come soon enough. (I may be a little late with this advice, as I see you have already started on Mirapex.). Would it be too cynical if I were to suggest that some doctors are more interested in building up a big data-base of information on the newest, sexiest treatment of the month, than ensuring that patients are getting the most appropriate drugs for their situation? Finally, I think you are doing the right thing keeping your drug intake as low as possible, consistent with satisfactory relief of symptoms - I have a policy of keeping any increase in meds to the minimum, and just giving way stap by step. I think this is what has enabled me to use levodopa for 17 years, and still get useful mileage out of it. I have run on for longer than I intended, as usual. I hope it is of some use. Regards, -- Brian Collins <[log in to unmask]>