Dear listmembers,
A PWP friend is in hospital due to medication problems, and I'm hoping
that someone can help me understand what is happening.
Since being weaned off Tasmar early this month, my friend has gone
steadily downhill, but it isn't just been because of the Tasmar. I feel
his medications have been out of control for a long time.
He was taking Sinemet, regular and CR, but his dosage kept climbing. He
had been part of a Mirapex study, and continued taking it when the drug
study was finished. I thought he should be able to decrease his Sinemet
intake, but because he felt he wasn't getting much effect from Mirapex,
the Sinemet was increased and he has been taking 1600 to 2000 mg daily.
Then, when Tasmar was approved, it was added and for some time he was
taking all three, still with what I feel is a high Sinemet intake.
During the summer he began hallucinating, was dyskinetic, experiencing
extreme "on/off" times and lost thirty pounds, so Mirapex was dropped.
The Tasmar was increased to 600 mg daily, (gradually) which I believe is
the maximum. (?) At some point he was able to decrease the Sinemet to
about 900 mg daily, but that was short-lived and the Sinemet climbed
again.
Then the bombshell. Tasmar was withdrawn from the Canadian market and
early this month he was weaned off it, and Requip was started. After the
fourth week, though he had titrated up to the recommended amount, he
began having severe "off" times. More adjustments were made, (increase
Requip) but the Sinemet remained in the 1600 to 2000 mg range. Two weeks
ago he got to the point of being "off" more than he was "on."
After a frantic phone call from his wife yesterday, we got him admitted
to the hospital. He hadn't been able to swallow, he is now almost
completely immobile, and in severe pain from muscle cramping.
The last instructions from the neuro before he left for Christmas
vacation, were 1/2 Sinemet, 100/25 every 1/2 hour, Requip 1 mg - I've
lost track of how often, Amantadine 100 mg in the morning, Amitriptyline
10 mg at bedtime, Tylenol, and the last I heard tonight was that they
were going to give him morphine, all of which, BTW, is being
administered through a tube in his nose. It seems as if the PD meds have
stopped working.
He is no better tonight and his is wife is exhausted. I'm sorry for
this rambling post but Al and I and a couple of others from the support
group who have been helping as much as we can, are getting tired and we
are all very worried. Any suggestions would be very much appreciated...
Judith
--
Judith Richards, London, Ontario, Canada
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