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GeorgeNW

What’s a benefit of starting Requip XL and not sinemet

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What is a benefit of starting Requip XL and not sinemet? Right now I am taking azilect 1mg which helps a little with slow movement and stiffness. Tremors are not affected. Reading about side affects and evaluating should I ask MDS to try sinemet first just to see what will be improvement. Is it common to have a success with Requip XL over a long run( year or more ) or it just usual  transitional phase to sinemet .  I am 38 year old and diagnosed 5 months ago. Need to start meds to keep functioning at work.

Edited by GeorgeNW
Sinemet

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George,

It is very common fro someone your age to start with a Dopamine Agonist, like Requip, because the younger onset group is very well controlled on this group of medications. The XL version of Requip is also beneficial due to it's one a day dosing. Lastly, the side effects with Requip are very minimal when thr Dr. uses the "start low and go slow" theory. This basic theory is that a medication should be started at a very low dose and the dosage should be increased slowly. Some parkinson medication can be increased every three days, while others should only be increased every week or so. When the medication is started at too high of a dose or increased to quickly, The odds of of an adverse reaction or a side effect is very common

Sinemet does work well, but like I said earlier, the young onset group responds very well to this group of medication. Many times when Sinemet is used in someone with young onset parkinson's disease they may run into the medication not working as well when the disease progresses. Another reason is that if Sinemet is started on a younger per that over time Sinemet may have to be increased  too high which could require the patient too take too many tablets too many times a day.

I hope this helps and please keep me posted.

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Thanks for your detailed answer. Yes my MD suggested slow approach starting with 2mg and increasing to 6mg over a period of 3 weeks. I guess I will start soon with hope if avoiding scary side effects.

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GeorgeNW,

I'm glad I could help. If you need anything else, please feel free to contact me.

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Hi there,

Sorry for jumping in to this thread - hope that's ok.

As I started on a low dose of Sinemet CR (which I am still on), in the future might there be any benefit of starting an agonist as the disease progresses.  Or does it not normally work that way round?  

I'd be interested in your thoughts.

Thanks

Nick

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Nick,

What I sometimes see is a Dr. will use Sinemet for about a week to reassure the diagnosis of Parkinson's. If the tremors go away, then the diagnosis of Parkinson's is correct.

After that, in patient's who are under 60 years old, I usually see an agonist used. When that no longer seems to be effective, then a change to Sinemet may me in order.

Keep in mind that along with the agonist the Dr. may add on other meds, if needed, for dystonia or gait (walking/movement) issues.

I rarely see Sinemet used before another medication unless there is some other extenuating circumstance.

I hope this helps and please keep me posted.

 

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Hiker,

Besides an agonists, or MAO-B Inhibitors, the other options may be amantadine.

in severe cases, a Dr. might try Apokyn. It it a quick injectionthat can pull someone outof an off period very quickly and is not usuallyjust used for hair problems.

I hopethis helps and please keep meposted. 

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