On Tue 14 Sep, Clare Wilson wrote:
> In a message dated 9/14/99 7:40:06 AM Mountain Daylight Time,
> [log in to unmask] writes:
>
> << ReQuip, which caused severe joint and
> muscle pain, and a general worsening of arthritis >>
>
> Barb and Carole: this is interesting. Because I am coming down off
> Requip to check out the possibility that it is exacerbating my 'restlessness'
> or akathesia, whatever. I'm going up on sinemet CR 25/l00 at the same
> time. During the past l8 months, my neck and shoulder stiffness/pain
> has become more of a problem. It sounds likely after your reports, that
> Requip has been responsible for my own complaints, including lower
> back and hip pain. Brian is probably right...."don't have anything to do
> with the agonists!" I'm halfway to being completely off Requip. Wish it
> didn't take so long to titrate.
>
> Clare
>
>
>
Hello Clare; I just want to clarify your quote for others who may read this
correspondence and draw the wrong conclusion: I disagree strongly with
people who are urging newly-disgnosed PWPs, or those who may only be 1 or 2
years since diagnosis, to start taking dopamine agonists in place of Sinemet
/Madopar. I slso disagree strongly with those who seem determined to stuff
as much as possible of any new drug down the throat of the poor PWP. Where
is the long-term plan? (We all know that PD is progressive: so the treatment
should also be progressive).
I do strongly agree with the use of dopamine agonists in the later stages,
howewver, where the levodopa which we need to make up the deficiency in our
brain begins to be threatened by dyskinesias. It is at this point that I
advocate the introduction of a dopamine agonist -not much - just enough
to allow you to operate smoothly. In this way, I have kept going for the
last 6 years, and my dosage of Permax has gone from 0 to 5 mg.
Here is the breakdown of my dosage; Diagnosed Age 39
Started Levodopa Age 40
Started Permax Age 54
Current age Age 59
I think that any PWP, at an early stage in the illness, should be presented
with a forecast by his neurologist, perhaps not as aggressive as my timings,
but sufficient to enable the PWP to d a little forward planning in his life.
Regards,
--
Brian Collins <[log in to unmask]>
