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Found 18 results

  1. Dear Doctor Okun! I am 65. Work full time. Diagnosed with Parkinson’s in 2012. Up till August 2018 was treated with Sinemet / 2 tablets 100/25 X 5 times a day – every 3 hours (7 AM to 7 PM) and Mirapex (1 mg tablet X 3 times a day). While my Sinemet dose has been increased slowly, my Mirapex dose has not been changed since 2015. It was never perfect. But I functioned some-how till summer 2018, when my condition worsened. I lost my sleep. My stomach was irritated. I would sleep 2 hours max at night; was mostly restless at night. During the day I was very tired, my tremors got worse.The single dose of medication would wear off in about 2 hours – did not last for 3 hours. My neurologist suggested to try Neupro/Rotigotine – 24 hours patch. We started one month ago. I had to take some time off the work as it did not go as fast and smooth as we hopped! I withdraw from Mirapex (very slow - as I experienced withdrawal effect when tried to go faster initially) and gradually increased the Neupro dose – 2 Mg - first week – 4 Mg - second week, –6 Mg - ... - 8 Mg ... I tried 8 mg Neupro/24hr patch for a few days but felt that the dose is too strong for me. - felt it was overstimulating my brain. At this point in time is around 1.5 week as I am on Neupro 6 Mg/24h patch and 2 tabs of Sinemet 100/25 X 5 times a day – every 3 hours (7 AM to 7 PM). Sleeping got bit better / 4 – 5 hours at night. My stomach has calmed down. But the following feels worse. At night, the new medication seems having too strong drowsy effect on me. It is very hard to wake-up as needed to go to bath room at night; very difficult to move in bed, stand up from the bed and walk at night and in the morning - my wife helps me. I did not need my wife 's help at night before when using Mirapex. The balance and moving/walking at night /morning is very poor and laborious. In the morning, I have to take Sinemet right after wake up - only after that I can dress, brush my teeth, walk down the stairs, etc ... I could dress slowly and go down the stairs prior to taking any Sinemet in the morning prior to my medication change. During the day - I feel that I am under-medicated overall. My Sinemet dose wares off in about 2.5 hours. My balance, walking is worse, my endurance and energy decreased compare to my "best days" back in May - June 2018/ To be fair, I had some worse days with the Mirapex also. Currently when waiting for Sinemet to go “ON”, my neck, shoulders, legs, arms become very stiff; hands intensively shaking . Usually it takes 30 min or less for Sinemet to get “ON” . Shaking stops. Muscles relax. I often feel a bit drowsy during the day time also. If I take a nap or fall asleep during the day - waking up takes long time and for the following dose of Sinemet to get ON - would need to wait twice as long as usual - up to 1 hour. I am sill off work. Would love to go back to work when my condition improves I read your book: Dr. Michael Okun: “Parkinson's Treatment: 10 Secrets to a Happier Life”. Tried to think on how to apply some of “the secretes” to my case. Questions : I was thinking that I may be able to tune the Sinemet time/dose to optimize the overall medication action. I could try to keep the dose of 2 tabs of Sinemet but apply it more often - every 2.5 hours (instead of 3 hours) starting at 7 am and continue to 10 PM when I go to sleep. 1) Is this the right approach to try in my case ? What do you think ? 2) What could you recommend to try to optimize my Sinemet with Neupro medication? 3) What else would you recommend to try at this point? 4) Could it be that Mirapex ( 1 mg X 3 times daily) was providing a stronger support compare to Neupro 6 Mg/24h patch at the day time ? Thank you and best regards!
  2. sheryl Ann

    medication schedule

    Dear Mark, I currently take 1/2 of a 1.5MG of Mirapex four times a day. I also take one 25/100 Sinamet three times a day. Could you please suggest a schedule? Should I be weaning off the Mirapex since I started the Sinemet or are they ok together? My stiffness has become a little worse and I feel my tremor is trying to come back. Should I request an increase in one of them? I don't know whether to mention it to my doctor, because my life style is not affected. Should I hold off on increasing meds as long as I can, or take whatever it takes to relieve the symptoms? I was diagnosed six years ago and am 67. By the way, I feel extremely lucky. I have no serious side effects from these meds. Thank you for your time, Mark Sheryl
  3. Susan Pacey-Field

    Not sure of Diagnosis

    I am waiting to see a nurologist, so right now I am seeing a nurse practitioner. She suspects I have Parkinson's so I have been taking four different medications in a row. First, I took C/L and it made me very sick and nauseous. Next, I took Pramipexole (mirapex), first at a .25 level and then at a .125 level, both of which made me nauseous and extremely tired and dizzy. The Gabapentin at 100 mg, not only made me sick, but made my tremors worse. The Topomax, at 100 mg was way too strong, it knocked me out. I had previously used it for two years at a dosage of 25 mg for migraine prevention, stopping in 2011 due to an increase in migraines. I do tolerate it well at that dose. Is that medication routinely used for Parkinson's? Are there other's that someone like me who is medication sensitive and uncertain of my diagnosis can use?
  4. I've been a runner for 30+ years, now 49 years old, on Mirapex ER, amantadine, and Azilect. Diagnosed by Datscan in Nov 2012, symptoms since maybe 2009. I'm rapidly becoming a walker rather than a runner due to gait difficulties with my left leg. Pelvis tilts funny now, left foot drags and scuffs, left knee hyperextends. Wondering if anyone has found that a change from a dopamine agonist to Sinemt has helped (at least for a while) with running or any kind of gait issues? Thanks very much.
  5. Good evening, My local neurologist has prescribed one sinemet 25/100 three times a day along with one and a half Mirapex .5mg four times a day. I am most uncomfortable with my right foot extremely swollen. I feel the discomfort all the way up to my knee. The skin is stretched to the limit. I received a second opinion at Emory in Atlanta. He said I was taking too much Mirapex. My local doctor prefers I continue with the current dose. He says I am new at taking the sinemet and he wants to keep the dose of Mirapex the same in order to best see the effect of the sinemet. How long is this necessary? My reaction to the Mirapex is always worse in the hot summer. Thank you in advance for considering my question. It is most appreciated. Sheryl
  6. PatriotM

    Drug Free

    I have now been drug free for over a week, after SLOWLY titrating my self down and off of Mirapex. I was concerned that the Mirapex was increasing my fatigue. So far, I am staying awake about 3 hour longer in the evening; my sleep is less fragmented; and I am a less fatigued during the day. The down side is that the dreams have all but stopped, which is not good. As for other symptoms, my tremor has slightly increased and rigidity is slightly worse when first getting up in the morning and after sitting for a long period of time. Fortunately, my rigidity was already significantly better due to my aggressive exercise program. My plan at this point is to continue the aggressive exercise program and to remain drug free. The exercise program has done more for my PD than the Mirapex ever did.
  7. Dear Mr. Comes, My mom lives with PD for 6 years. She takes Mirapex against PD and Ramipril to treat high blood pressure daily. 1. Can Ramipril potentially worsen PD symptoms? 2. Is it possible that Ramipril may collide with Mirapex and provide negative results? Thanks, Irina
  8. chipmunk32

    Crazy sleep patterns

    dx aug 1,2014. I am taking mirapex .125 3xd and my sleep pattern is highly disrupted. I go to bed at 10:00 then wake at 1AM and stare at the ceiling for an hour before returning to sleep. This morning I was wide awake at 3AM, came downstairs and ate breakfast. Very hard on spouse. Is this because of PD, the meds, will it ever stabilize??? Thanks
  9. I have read about all the possible negative effects of Mirapex and wonder when these might begin to occur. I have been on this drug for PD since Aug 4th 2014. I was diagnosed August 1st, same year. Thanks
  10. sheryl Ann

    Nail Infection

    Dear Dr. Okun, I have taken Mirapex for several months now and Azilect before that. I have had very few side effects. The few I have, I can live with easily. A curious observation; I have had one toenail issue since starting Mirapex. I took an antibiotic and it disappeared. I have had another toenail issue crop up. There is a protrusion under the nail itself that has broken through the nail. No pain or discomfort. I am seeing the doctor in two days. My question...can Mirapex be connected to unusual nail infections? I have never had a problem in my life with my nails until now. Would Requip cause the same problems? Thank you for your time, SL
  11. Lis

    Mirapex PD

    Dear Dr Okun, My Mom has PD for 5 years and is now on Mirapex PD (pramipexole prolonged-release). She takes 1.5 mg early morning around 10 am but experiences very mild improvements only at the end of the day around 10 pm. What's the best hour of the day for taking Mirapex PD? Do you have any assumptions why she feels changes almost after 12 hours after receiving her medications? Regards, Irina
  12. tswrace

    Stopping Mirapex

    I appologise for taking time on this forum from so many people that are seriously ill with Parkinson's Disease and for the length of this post. I too am seriously ill but my disease is Post-polio Syndrome. The comnmon symptom of the two that brings me here is Spasms. I have had spasms for 15 years. I also have chronic fatigue that disables me everyday at 12 Noon. Since 2006 the spasms begin within 45 minutes of me laying down and closing my eyes. I had a stroke in Dec. 2010. I was introdiuced to a neurologist in the hospital that said she was going to "cure" my spasms. She prescribed mirapex (pramipexole) for me begining at 0.5 Mg. I complained to her from the first dose about the insomnia that the mirapex caused and later about the constipation. The doctor would never do anything but deny that mirapex caused the problems. I began splitting doses and taking them earier in the day to reduice the insomnia. In June od 2012 the doctor increase my dose of pramipexole to 1.0 Mg. per day. I began taking the dose at 1:30 PM to avoid insomnia. For the next year I experienced sleep deprivation, 4-6 nights a week with less than two hours sleep, or no sleep at all. The doctor refused to adjust me mirapex in Dec. 2012 when I was unable to leave the house to make my appointment with her. In Aug. 2013 I began seeing a psciatrist for mental things that were happening to me. I described what was happening to me and he immediatel said that it was being caused by the mirapex. I was having hallucinations. So I had gone through a year of sleep deprivation and hallucinations because of the mirapex. If I reduce the mirapex the spasms increase in frequency and severity immediately. The Psych. and I have tried several medication to replace the mirapex without any success. Those medication are metaxalone, amantadine, methocarbamol, and baclophen. Could you please help me with suggestions for medications that will allow me to discontinue the mirapex without incurring more ontoward side effects? Thank you, TSWRACE
  13. Hope

    Flu-like feeling/ nausea

    I was lucky to have a good response to Mirapex and felt pretty good about 8 months after diagnosis. But then my doctor suggested I try Elavil (selegiline) because he believes it has a superior neuroprotective effect to Azilect. I added it while trying to go down on the Mirapex. It did not have the same improvement in motor symptoms. But after struggling for months with insomnia (no sleep for more than 75 minutes at a time and less than 4 hrs a night) I finally stopped it. He wants me to try again as soon as possible. Now I have regularly the problems that I guess are what people mean by "off" periods. Around late afternoon each day (and sometimes after exercise) I get chills and nausea. At first I thought I had caught the flu--- week after week I attributed it to that. But now I am realizing maybe this is the "off" thing I have read so much about. I recently tried Mirapex ER (3mg) and it was like a poison pill. Violent nausea and diarrhea. Worst 24 hrs I can remember spending. So I am wondering if these are drug withdrawal symptoms from the Elavil; if the PD just progressed since diagnosis to include these and if this is part of the "off" syndrome. I do shake a little more during these periods but that is not the obvious part of it. It's been such a disappointing few months and for the first time, challenging to work. I have to lie down with a heating pad until it passes. Luckily my boss has been very kind and gave me a great office with a couch when I informed her. I live in So. California, and I feel like I need a down jacket handy for these temperature changes. Any help in deciphering htis would be greatly appreciated. I have always had nausea if I don't eat when I take the Mirapex so I find myself delaying taking that third dose-- also because I can't figure out if it helps or hinders sleep.
  14. camt68

    mirapex to ropinirole

    Dr. Okun, I was on Mirapex ER for over four months, taking 3 mg daily. During that period, I did not have any symptom relief. My MDS suggested increasing my dosage, but due to the side effects, we discussed other options. I am now taking Ropinirole 5 mg three times a day. I've taken Requip 3 mg in the past and it worked pretty well with little side effects. Prior to taking Mirapex, I was not taking any medication and detoxing my body of heavy metals and pesticides. Its been about a week since the switch and I feel a lot worse, experiencing balance issues, difficulty standing and walking, freezing, and an increase in tremors. Am I feeling worse due to the transition? If my MDS was going to increase my dosage to 4.5 mg, am I taking the correct dosage of Ropinirole? How would I feel if I am over medicated? Thank you for your time.
  15. bettersamson

    Question with Neupro vs. Mirapex

    Dear Doctors, My mom has been diagnosed with PD for almost 10 years. Her neurologist recently prescribed her with the 2mg Neupro less than a month ago. Her doctor told me that the neupro works like Mirapex (she is currently take Mirapex 1mg 3 times a day) and her doctor said she doesn't need to reduce the dosage of the mirapex. Since then her movement seems a little bit smoother than before, however, she seems drowsier and can not maintain her balance at all. In addition, her sleeping problem has been worsen due to anxiety. I read the instruction that comes with Neupro which says that oral medication may need to be adjusted with using Neupro, thus I can't help think this might caused by the combine usage of Mirapex and Neupro. Therefore, I wonder is my mother being overdosed with Mirapex? or is the Mirapex level too high? and should she reduce the dosage of the Mirapex. I contacted her neurologist for this question, but, like usual, never got any response from him. Thank you
  16. Hey all, I'm new to this forum, as I finally got a Young Onset Parkinson's diagnosis recently. My Dr. told me that since I'm 34, Levodopa can be toxic after 7 years, so he wanted to put me on a milder med (Mirapex). I've only been on it for three days, and perhaps I'm being too impatient, but my question is how long does it take til you see an obvious result? I take 4 pills of .25 Mirapex 4 times a day, and increase to 2 pills four times a day next week, then 3 pills four times a day the third week, then finally 4 pills four times a day. Am I being too eager? Thanks
  17. Kristakj78


    I have been on Mirapex for three days now. I have a recent Parkinson's diagnosis. How long does it take to work? I'm only on .25 mg 4x a day, then next week .5 mg 4x a day, then .75 4x a day the 3rd week, then he said finally 1mg (4 of the .25 pills) 4 times a day for the 4th week. Am I being too eager? I've only been on it for 3 days now, I'm being too eager I'm guessing.
  18. Hey all, I'm new to this forum, as I finally got a Young Onset Parkinson's diagnosis recently. My Dr. told me that since I'm 34, Levodopa can be toxic after 7 years, so he wanted to put me on a milder med (Mirapex). I've only been on it for three days, and perhaps I'm being too impatient, but my question is how long does it take til you see an obvious result? I take 4 pills of .25 Mirapex 4 times a day, and increase to 2 pills four times a day next week, then 3 pills four times a day the third week, then finally 4 pills four times a day. Am I being too eager? Thanks