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On Tue 06 Jan, jim and emily jackson wrote: > On Jan. 4 Manfred Heiderich wrote: >I have several questions: > > > >1. My symptoms are mild. I feel hardly handicapped at all. Why then should > >I start drug treatment (with Sinemet CR)? My understanding is that no PD > >drug (with the possible exception of Selegiline) actually checks the > >progress of the disease; they merely mask the symptoms.... > > > We, too, asked this question. Results for us, was that Jim is taking > seligiline, for the reason above (sorry, Brian), and started on Mirapex in > August. After slow upward titration on Mirapex, he seems pretty stable, > and we don't see much in any worsening of the PD symptoms--that is, he has > tremors under stress, either emotional or physical (like sneezing, coughing > or carrying something). They rarely appear at rest, and are certainly very > manageable. The only other problem, aside from fatigue, has been his right > foot "giving out" and possible internal tremors. > > Our new neurologist, when queried, answered that her first choice of drug > for PD is indeed sinemet, but she did not, at our first appointment several > weeks ago, suggest any change in our medications, as Jim continues pretty > well. As other listmembers have indicated, it's very personal, what works > for you and what your neurologist likes to work with. For us, anyway, the > use of the seligiline with dopamine agonist (Mirapex, in this case) seems > to have been the right choice. We can always start on sinemet later > if/when it would improve things for Jim. BTW, I read somewhere that > seligiline is a mild antidepressent--a plus in our situation. > > Emily Jackson > > > [log in to unmask] > > > Hello Emily, my first reaction to your post was 'Well, even if I don't approve of everything, they can't go far wrong at that early stage. Now, having digested things for a while, I do have some comments: First ; Selegeline - don't feel guilty; It's not a major issue - just remember that the 'anti- depressant is probably the effect of the amphetamine (speed) which is produced as the Selegeline breaks down, so watch out or he'll be off partying all night! What does concern me is that once again, you may not know it, but you are in the front line of an undeclared test: A test to answer the question 'What happens if we withold the levodopa and give only agonists ?' And to add to my worry, you have been prescribed Mirapex- Still very much an experimental drug if like me, you believe that the pre-release testing, incredibly expensive though it may be, is only the first step in determining the safety of a new drug of the potential that these agonists posess. You are probably OK now because it doesn't take too much agonist to do the job (just how much have you been prescribed, and what is today's recommended max daily intake? Never lose sight of the fact that the frightening sories about Sinemet side effects are mostly dusted off and brought out during the clearance of yet another agonist:- Hardly an unbiased audience.The only significant effects of an overdose of levodopa is excess Dopamine production, causing diskynesias. Not pleasant, I agree but compared with the dark side of some of the agonists, the levodopa looks positively care free. Regards, -- Brian Collins <[log in to unmask]>