One year ago I was writing to you for advice concerning sleep (or lack of) and you were able to offer practical suggestions which allowed me to put together my meds. in such a way that my sleep pattern improved immensely. I am facing this problem again and I am hoping you may be able to point me in the right direction.
Up to May I was taking 1 1/2 tabs. carbidopa-levodopa (25/100)4xday plus Ropinirole 1 tab. (5 mg.)4xday plus 1 tab.Azilect(1 mg.)day.
This worked really well. However, in May I reduced the Ropinirole from 5mg. to 4mg. and this change has either initiated or either just coincided with a decrease in the effectiveness of this combination of meds. I now have increased tremor and rigidity (especially in my hand) along with decreased sleep.
I find my meds. must now be taken at 3 1/2 hr. intervals rather than 4 to 4 1/2. My MDS suggested increasing the CL to 2 tabs.4xday. But this caused an increase in tremor etc. so I tried going back to the 1 1/2 tabs. at 3 1//2 hr. intervals. This has proved to work really well throughout the day, but the nights are a disaster. My MDS thinks I may need a total of 8 mgs. CL daily, and he has given me great latitude as to how to break this down so that it works for me. But I could use some input-should I add a 5th dose of 1 1/2 tab, of CL at around 10:30pm. I am currently taking the CL at 8 am. 11:30am,3:00pm and 6:30pm. and the Ropinirole at 9,1,5 and 9. I try to go to bed around 10:30 or 11:00, but I am waking somewhere between 1:00am and 2:00am as symptoms reemerge. Even a small dose of Ambien does not seem to be able to override the tremor etc. which recurs throughout the night. Any suggestions???
I have recently had 2 serious infections and I was treated with Cipro and Doxycycline over a 3 week period. I realize it's possible
that these circumstances may be having some impact on my PD symptoms. I would so appreciate any thoughts you may have to contribute. I totally embrace your belief that the best approach with PD is to start small and go slowly. And thanks again. Your positive attitude about PD is contagious.