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HI Ann, I can comment more as a patient than as a physician. Regarding the switch from Mirapex to Requip, I started Mirapex changing from Parlodel during a hospitalization when Mirapex was first released. My Neurologist switched me calculating the equivalent dose of Mirapex rather than disable me (even more) by phasing one down while increasing the other. The Requip was started after the Mirapex had reached beyond maximum dose without substantial (increased) benefit. The requip was better (for me). The switch was while I was at home and was a sudden change giving me again equivalent doses of Requip to the Mirapex. As time has progressed either the Requip has lost its effectiveness or my PD has gotten worse (unfortunately I think it is the latter). I currently am taking above the recommended dose and after getting lab work I likely will be increasing even more. If you can put off the Sinemet that would make sense to me- however if the Requip doesn't give you substantial reduction of symptoms- to a level where your life can proceed reasonably normally- I would not hesitate to add the sinemet. Sinemet can give a response in a few days but is usually titrated up slowly to give optimum effect. Good luck, Charlie serenityplus wrote: > Hi, > > I've been in the TEMPO study, which is a drug study for an MAO type B > inhibitor, much like Selegiline. I've been on open label with the dose > still blinded; also, I'm taking Mirapex, barely 1.5 mg/day (had some > dose limiting side effects, like sleepiness, but no orthostatic > hypotension. I've haven't gotten a good response to Mirapex, and I > feel, much as I would like to put off Sinemet (I'm 54, diag. a year > ago, probably had it from about '89) that my symptoms are really > getting in my way: tremor is essential, not resting, so it's not a > problem, but the inability to do much with my right hand, and dragging > my right side is getting to be too much. > > I'm concerned that trying another agonist like Requip will take > forever (My titration experience with Mirapex was VERY LONG) and may > not do any more, and may cause problems for nothing. I've read that > it takes weeks or even months to get an adequate response from > agonists. I've taken Mirapex, albeit in small increasing doses, since > last Sept. and it hasn't done much. I suppose the PD could be > outpacing the therapy also. Q: Does Sinemet take long to show a > response? How tough is it to come off Mirapex (though maybe I > shouldn't). Any strategies coming to mind on handling starting > generic carbadopa/levodopa with/without Mirapex? > > I would be grateful for any response. Thanks! > > Ann -- ****************************************************************************************** Charles T. Meyer, M.D. Middleton (Madison), Wisconsin [log in to unmask] ******************************************************************************************