I took my father to the nurologist today and the doctor switched his medication from Stalevo to Madapar. I hope it works better for him. Any views on this ?
For my dad: I took my father to the... - Cure Parkinson's
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38 Replies
•
Change over slowly,one pill at a time, changing one more after a few days or even a week. Rapid change can be very unpleasant.
• in reply toJoynb
Thanks but how? He used to take three stalevo tablets before so how can he switch to madapar now? Should he take one tablet madapar and then increase his dose? How do you mean one tablet?
Joynb• in reply to
Step 1: substitute Madopar for Stalevo first thing in the morning, take Stalevo the rest of the day. Do this for at least three days, more of there are any reactionssubstitute
Step 2: continue taking Madopar first thing in the morning and substitute Madopar for Stalevo at the second dose of the day. Again, do this for at least three days, more of there are any reactions
Step 3: continue taking Madopar first and second dose, substitute Madopar for Stalevo at the third dose of the day.
step 4: proceed in the same way for any further doses
All changed, with least risk of reactions
• in reply toJoynb
Thank you so much for this..thank you will do so, thank you
What was the reason your doctor gave for making the switch ? What strength Stalevo is he taking ?
• in reply toshelly9
my father was taking stalevo 50 mg with carbidopa 12.5 and 200mg entakapone,..he was taking these 3 times a day...now just yesterday the doctor switched him to madapar...but ı am scared of making such a sudden switch? also the doctor said he should 'chew' madapor but ı am reading the leaflet and it says it should be swallowed? ı am confused now....the reason the doctor switched was because my father feels tired all day and falls asleep often and also his walking has göne worse 
park_bear• in reply to
Does he have the typical Parkinson's resting tremor of hand / arm on one side?
How is his walking affected?
• in reply topark_bear
No he does not have tremor. But his walking is bad he is very slow and his arms dont move when he walks and his steps are very little..his posture is forward bent i realised however since he took stalevo his walking has gone worse he doesnt lift his feet when he walks
park_bear• in reply to
Does one foot move more easily than the other?
These symptoms you have set forth might or might not be PD. I know 2 neurologists say he has it but the lack of response to stalevo is a negative indication.
• in reply topark_bear
Yes his left foot moves more easily than his right foot. His right side seems to be slower. I am really sad to see him not lifting his feet when he walks..sometimes since he doesnt lift his feet when he walks I get scared he may stimble. He can eat drink shave and do other things with his own hands he doesnt have tremor but he is slow in walking..his speech his voice has gone softer too so i ask him to speak up when he talks
• in reply topark_bear
His dose of levadopa was three times 50 mg..since we saw no improvement the doc raised his dose and switched him from stalevo to madapar three times daily
• in reply to
At least 15% of patients with a diagnosis of Parkinson's disease in the population do not fulfil strict clinical criteria for the disease, and approximately 20% of patients with Parkinson's disease who have already come to medical attention have not been diagnosed as such.
• in reply to
The doc said im future dementia may follow with parkinson ...i really dont know...i asked the doc if he was sure of the diagnosis of PD with my father and he said that the clinical tests say so..
I really dont know..i dont know how the dose increase and med switch will work...the doc also said "try one day without any meds and you will see he will be worse off" :(.
• in reply to
The future may not "may follow with parkinson ..." Surely we must take responsibility for selecting the treatment, diet, supplement choices, etc. It is totally evident from reading others experience herein with opinionated doctors, incorrect dx and meds as well as 'closed mindedness' from docs regarding alternative treatment will lead many of us to the future dark recesses of Parkinson's.
• in reply to
Yes I agree with you totally..I just wish my I could talk to my doc like I can with you all in here but whenever I ask him something he gets so offended and says 'dont you trust me? This is beyond rudeness' bla bla and to be frank I get really upset with his attitute but he is the only well renown movement disorder specialist nurologist here thank you so much
he was taking stalevo with 50 mg levadopa, 12.5 carbidopa, and 200 mg entakapone
I am in the process of moving from Sinemet to Stavelo. I suggest you find patients who actually made the switch. My research did not find any who did. My doctor said Medapar was very similar Sinemet.
The entacapone in Stalevo (or its generic equivalent) is there to help ameliorate the medication off periods.
• in reply to
yes but stalevo didnt work well for my dad. he took it for 3 months but no sign of improvement infact hes göne worse
• in reply to
It may be that your Dad is not reacting to levodopa because his diagnosis of PD was not correct. MSA or PSP are other possibilities.
• in reply to
But they had an MR scan done
Greenday• in reply to
It is extremely hard for MRI to detect the atrophies caused by MSA, PSP or other parkinsonian syndromes and differentiate from PD, especially at the early stages of the disease and most specialists have not the expertise or tools required to analyze those scans anyway.
• in reply toGreenday
what does msa and psp stand for ?
Greenday• in reply to
Regarding MSA I thoroughly explained in your former post. healthunlocked.com/parkinso...
MSA:
emedicine.medscape.com/arti...
PSP:
emedicine.medscape.com/arti...
Both syndromes often have low response to levodopa
• in reply toGreenday
thank you so much for this
• in reply toGreenday
Thank you so much
• in reply toGreenday
I had three neurologists say that my father was Parkinson...but ı dont know
Greenday• in reply to
I personally better trust the machines than the doctors. PET and SPECT scans can differentiate parkinsons from syndromes. Did you visit a movement disorder specialist with expertise in PD? Maybe eventually it is all about the correct medicines, dosage and doctor. If you father won't see any improvement then other possibilities may exist. Also an exercise routine is equally important, you should not depend only on drugs.
• in reply toGreenday
yes the neurolgist is a specialist in movement disorder...ı wonder if madapar will work for him but ı dont know how should chew this tablet
ı dont know how to switch. the doc said just leave the stalevo and give him three tablets of madapar...but ı am worried
Greenday• in reply to
Both Stalevo & Madopar? I'm not sure anyone in this forum take both of this combination... Maybe your doctor wants to test his response to madopar first before switching?
• in reply toGreenday
No not the combination, the doctor had prescribed stalevo, which my dad took for 3 months..now the doc is switching from stalevo to madapar...
• in reply to
the doctor said my dad should 'chew' madapar and then drink water..but is that a tablet to chew??
Greenday• in reply to
chewable madopar??? Does your dad have swallowing difficulties? Ask your doctor why you dad needs to chew it instead of swallowing which is the recommended way.
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