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Mical

Levodopa not really working

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Hello All.

My partner is 57 and was diagnosed about 15 months ago. 3 months ago Levodopa/car was added to azilect and Sifrol.

Levodopa does not seem to be helping his tremor. His right foot tremor is barely noticeable but his right hand tremor is still significant and I don't think it's helping this at all.

How efffective should it be at controlling his hand tremor? Of course I'm now terrified he has a Parkinson's plus type.

He's otherwise going along well. If only this damn right hand tremor would get under control you wouldn't even know he had PD.

 

 

 

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Mical, 

You need to talk to his doctor. He may need to increase his C/L dose. Tremor is the hardest thing to capture.

Dave

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Many people believe that Sinemet (C/L) stops tremor & other symptoms. That's only true for some people, not all. I had a terrible tremor & took C/L & it did not help my tremor & in fact did very little for me, except it sometimes gave me a bit more energy, better mood, helped with sleep. Unfortunately, It also gave me dystonia after  only 1 year. I was diagnosed 2007 & was doing pretty well for several  years, except for the big tremor. Finally had DBS 2 years ago, which totally took away the tremor. Unfortunately, it also gave me some serious speech & language problems as well as balance problems causing falls, and now I also have severe hip/back pain (not sure yet if mechanical or PD). However, the tremor is gone, so DBS was well worth it. I wouldn't worry about  PD+ based  on what you said. Talk to  your MDS.

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I'm not sure why you are posting this question on the open forum, and not on the Ask The Doctor section, but levodopa doesn't always help tremor.

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Dopaminergic meds never did much for my tremor, and as others have indicated, that's not unusual. If need be, I can usually use relaxation methods, mental focus, and/or a bit of movement to temporarily stop the tremor. Your partner's probably figured out how to do the same. I understand this gets harder as PD progresses.

In my view, it's easy to put too much emphasis on tremor as *the* PD symptom--IIRC, there's even some evidence tremor is a sign the brain is using alternate pathways to allow more or less normal movement. Certainly, tremor-dominant PD has better prognosis (slower progression) than other forms. I think most folks w/ PD (myself included) find stiffness, slowness (bradykinesia), and dystonia more troubling than tremor. Not to mention balance and gait issues, and non-motor symptoms.

Is your partner's  tremor currently causing impairment or disability? Or is the primary issue that it makes it visually obvious he has PD?

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