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Dyskinesia Symptoms and Sinemet/Requip Ratio


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#1 JuggernautTCW

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Posted 22 September 2012 - 07:52 AM

This post is for my 60-year old mom with ~11 years of PD. She is roughly 4'11" tall and weighs 95 lb.

She has been experiencing severe dyskinesia during both on and off sinemet effect.

Her symptoms are:
- Right arm: stiff with dyskinesia
- Right Leg: stiff and cannot bend (cant get up from sitting position)
- Left arm: OK/normal
- Left Leg: dyskinesia but can bend

Given her symptoms, is there a way to tell if she is taking too much requip or sinemet? She currently takes 1mg of requip and and 1.5mg of sinemet and dyskinesia can start right after her first dose and lasts for 6 hours, so she cannot even get to the second one.

Also, given her symptoms, what would be the appropriate requip to sinemet ratio?.... It is sinemet that is causing the dyskinesia since it starts 15 min right after the sinemet dose, but her dilemma is that she cannot lower the sinemet dose any further, so she is looking to see if requip dose can be changed to help her situation.

#2 MComes RPH

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Posted 01 October 2012 - 10:56 AM

Please read answer in post "Medicine sequence: equip & sinemet"
Thanks
Best of health,
Mark R. Comes R.Ph.
"Ask The Pharmacist"
www.parkinson.org

#3 Jean Zwolinski

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Posted 12 November 2012 - 05:32 PM

hey mark i am having alot of trouble with peak dose dyskinesias,,,,,,in have dbs and have increased my dbs and trying to see if the long term use of amantadine is the culprit or is it the cr 25/100 , before i had trouble with dyskinesias i was at 2.4 right side of body & 1.7 lsb-neupro patch was 4mg, 25/100 cr & 3 100mg amantadine,,
now im at 2.7,1.9 / 3.75 neupro mg patch, 1/2 amantadine tid and 1/2 cr four x' a day(every 4hrs) but still dyskinetic,, and thoughts,,,,??
(my dyskinesias can begin like 30mins after and last 1 1/2 hrs ugh, its ugly......HELP!!!!!!). can u plz reply to jeanz7@aol.com i would truely appreciate it. i remember meetiing at a couple of conferences n i am a good friend of thomas berdine s out of alb, new mexico.......im having alot of spinal s1-l4,l5 back issues,,,,,,,,so this dykinesias is not any fun, they there day i was in so much pain, i usu am a frequent visitor of my chiropractor , i found out that i had a unaligned bone in my hip area
and pinching a nerve........ iam a mess.................is there such a drug idazoxan to help counteract my dyskinesias............it is such a roller coaster ride..

#4 MComes RPH

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Posted 13 November 2012 - 10:51 AM

I will send through email for your confidentially request.
Thanks

Best of health,
Mark R. Comes R.Ph.
"Ask The Pharmacist"
www.parkinson.org

#5 Jean Zwolinski

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Posted 02 May 2013 - 06:33 PM

hello again mark, i was wondering, i am still having dyskinesia problems, peak dose and end of dose, i now take 2 100 mg amantadine tid 6am and 12pm,(instead of my every three hrs with 1/2 sinemet cr & 1/2 tablet generic amantadine_is this any good??
then i am increasing my 1/2 sinemet crs more but for as now it is usually every 3-31/2 hrs. but still in adjustment period, i mean i used to get these mean dyskinesias attacks i call it cause i would go as far as to freak out by walking crooked-twisted like, sweat, sob, what a roller coaster ride per say!!couldn't stand myself- did you ever hear of this?? then one day i told my 82 yr old mother, i drew a picture of a wave-like from 1-20min peak-3hr dyskinesias again, my life cycle ugh-not so nice
hence the two drugs together cr&amantadine do they bang off each other??? doing that ev 3hrs(cause when i was doing good oveeeeer a year now still trying to feel good again-i used to spread a whole red amantadine capsule ev 6 hrs-good or bad MY FRIEND. MY question is i want to cut back on my dyskinesias along with my strength needed. PLEASE ADVISE MARK THANKS AGAIN JEAN from Buffalo

#6 MComes RPH

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Posted 03 May 2013 - 11:34 AM

I posted your question so ot would be easier to handle 1 issue at a time.

hello again mark, i was wondering, i am still having dyskinesia problems, peak dose and end of dose, i now take 2 100 mg amantadine tid 6am and 12pm,(instead of my every three hrs with 1/2 sinemet cr & 1/2 tablet generic amantadine_is this any good??
THIS IS WHERE YOUR ISSUE IS STARTING. THIS DOSE OF ALL 3 SHOULD LAST LONGER THAN WHAT YOU ARE TAKING.
Then i am increasing my 1/2 sinemet crs more but for as now it is usually every 3-31/2 hrs. but still in adjustment period, i mean i used to get these mean dyskinesias attacks i call it cause i would go as far as to freak out by walking crooked-twisted like, sweat, sob, what a roller coaster ride per say!!couldn't stand myself- did you ever hear of this??
YES I HAVE HEARD OF THIS. AT THIS POINT IN THE DAY YOU HAVE MAX'D OUT "YOUR" DOSE THAT YOUR BODY CAN HANDLE. THEREFORE YOU ARE EXPERIENCING THE DYSKENSIA.
hen one day i told my 82 yr old mother, i drew a picture of a wave-like from 1-20min peak-3hr dyskinesias again, my life cycle ugh-not so nicehence the two drugs together cr&amantadine do they bang off each other??? doing that ev 3hrs(cause when i was doing good oveeeeer a year now still trying to feel good again-i used to spread a whole red amantadine capsule ev 6 hrs-good or bad MY FRIEND. MY question is i want to cut back on my dyskinesias along with my strength needed. PLEASE ADVISE MARK THANKS AGAIN JEAN from Buffalo 
JEAN, WE NEED TO GET YOU'RE DRUG REGIME STRAIGHTENED OUT FOR WHAT IS GOOD FOR YOU. PLEASE DO THIS FOR ME. RELY TO THIS POST JUST LIKE THIS EXAMPLE BELOW:

MEDICATION DOSE # OF TABLETS TIME
AMANTADINE 100MG 1 6AM
SINEMET CR 50/200 1/2 8AM
Eat 9AM

And send it back to me so I can get an EXACT SNAPSHOT of your dosing schedule per day. Also put in what time you eat. You don't have to tell me what you ate, just write like I did above. This way I can hopefully wreak it for you and we can get your quality of life back on track.
Please get back with me, I am taking a vacation this weekend, so it will probably be Monday.
Hang in there, together we can do this.
Best of health,
Mark R. Comes R.Ph.
"Ask The Pharmacist"
www.parkinson.org




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