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Dear Bob, Have you spoken with your neurologist about your "freezing" episodes? A possible adverse effect of amitriptyline is "parkinsonism." (Listed in the drug monograph): "Peripheral nervous system adverse reactions can occur during therapy with tricyclic antidepressants. Tremor may result from norepinephrine reuptake blockade. Rarely, extrapyramidal symptoms can occur in both young and elderly patients. Parkinsonism is more likely to occur in the elderly, especially if they are receiving high doses." Perhaps you could speak with your physician about this, as you're taking it at bedtime, which is about the time the "Freezing" occurs. S/he might wish to prescribe another medication in its place. Also, although you're taking Ultram and amitriptyline several hours apart, could it be possible they are interacting in some way? Tramadol and Amitriptyline Tramadol causes seizures in animals, and has been reported also in humans receiving large doses. Concomitant administration of tramadol with any other agent that lowers the seizure threshold may increase seizure risk. Post-marketing reports of seizures have been noted primarily in patients receiving tramadol with either tricyclic antidepressants or selective-serotonin reuptake inhibitors. Tramadol also inhibits the uptake of norepinephrine and serotonin which may affect patients taking MAOIs. Caution is advised in concomitant administration of tramadol with MAOIs, phenothiazines, antidepressants, antipsychotics, and other drugs that reduce the seizure threshold. Naloxone can also increase the risk of seizures. My very best regards, Kathrynne double a enterprises wrote: > > I received a message from Ivan Suzman yesterday, and he gave me some ideas > which were really helpful that I thought I would pass on to anyone else who > is new to PD, and he also brought up some questions I thought someone else > might be able to answer. > My neuro has me on the following schedule of meds; > 7:00am sinemet (or when my wife can get it to me) > 1 hour later, Mirapex, 1mg > Sinemet CR > Ultram (for anti-inflammatory) > Vicodin for joint pain > > 4 hours later, same minus vicodin > > about 4:00, I need to "boost" with Sinemet > > 5 to 6:00pm, Mirapex, Sinemet, Ultram > > 10:00 clonzapam 1mg, and amitriptyline, 50mg > > About 10 or 11 pm, my hands begin to curl up, and then legs and I'm "frozen" > until morning > when the sinemet kicks in. > > I usually take 1 to 5 pain pills per day, with an average of 2. > > Ivan suggested the clonzapam might not be good for someone with pd, and that > I was going too long between Sinemet doses, thus causing insomnia and the > freezing up. As an aside, he mentioned that when sinemet doses are too > high, you feel hot and sweaty, and when too low, your hands and feet become > cold. I really found that helpful since my hands and feet literally become > ice cold to the touch when they aren't working. > Last night I added Sinemet about 11:00pm, and again about 2:00 am, and > it seems to work. Can anyone else suggest changes I might need to make, and > what about the risk factors associated with the non-pd meds I'm on? I know > about the dangers of the vicodin, but not the other medicines. Thanks in > advance for any help or comments, > Bob [log in to unmask] -- Kathrynne Holden, MS, RD "Nutrition you can live with!" Medical nutrition therapy http://www.nutritionucanlivewith.com/ Tel: 970-493-6532 // Fax: 970-493-6538 "If we knew what it was we were doing, it would not be called research, would it?" -Albert Einstein