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On Sat 28 Feb, Debbie White wrote: > I realize that I seem to be posting the same questions over and over, but > I'm exptremely frustrated, confused, and getting defeated by what's going > on with my mother Joyce (68/1 year). She has been titrating up to Requip > and using Sinemet and is just continuning to get worse in every way (that > is, not one of her symptoms is better or even leveling out). She is now on > 2.5 mg Requip 3x/day and 25/100 Sinemet in the morning and in the afternoon > (that is 2x/day). I realize she is not on high doses, but shouldn't she > feel SOME relief (she doesn't even feel any kick in with the Sinemet). Her > worsening (and only) symptoms are rigidity in left hand (and arm a bit), > bradykinesia, tightness in the chest, slurred speech, and an active tremor > (not a resting one). Could it be that she has atypical PD and that these > drugs will not help even one of her symptoms? Thanks > > > Debbie White > [log in to unmask] > > > Hello Debbie, I have not been following your mother's progress (or lack of it), but I came to an instant conclusion when I read your latest posting. That is that you mother is probably miles away from an effective dose. As I recall, she had characteristics which showed a need for a surprisingly high dose of Sinemet for her relatively short time since diagnosis. However, if thats what she needs, then thats what she should have. I don't have personal experience of Requip, so I cannot judge the magnitude of the dose that she is on, but you should remember that these agonists are all very similar in their ability to replace Sinemet in the brain. That is to say: if you set out to take a high but safe dose of Requip, then the quantity of Sinemet that it would replace will be similar for most of the agonists currently available. Where they do differ is in their ability to produce different varieties of side-effects. That is why I stick with Pergolide. So far, it has given me no side effects. The makers of Requip (Smith Klein Beecham in the UK) were enterprising enough to try Tequip without any levodopa on some early stage PWPs, and reported that it was as effective as Sinimet AT LOW DOSES, and could even replace Sinemet altogether. I was unimpressed: They were careful to emphasize thet they were talking at low doses only. i.e. newly -diagnosed PWPs , and it takes very little of anything to make a significant effect on an early stages PWP. The odd Sinemet 25/100 is unlikely to provoke much of a response from your mother either. she needs to be taking about 800 mg per day of Sinemet, not 200. I have found it far easier, having set up my system for optimum dosage of Sinemet (Madopar actually, but it makes little difference) I then held that value constant (have done so for 4 years now) and adjusted my intake of Sinemet upwards as time went by. Well, that's made a big hole in your schedule. but I think is is probably the right way for you to go. Remember, I am not a doctor, so maybe you should use my comments as a guide when talking to your neuro. I would give up the Titrating- for a while; you should be out there in the big time! Hope this helps, Regards, Brian Collins <[log in to unmask] -- Brian Collins <[log in to unmask]>