another new trial for me neupro 4mg /24 h other name known as rotigotine

[elsidwarrior]

it only seems to make freezing worse and i can not say it has helped me in any way at all ANY ONE KNOW WHY

[Pnyldy]

2 mg helped me. When we increased to 4 mg I did not like the effect.

[park_bear]

This medication is strictly for symptom relief. If it does not help you no reason to take it. If you have been taking for a while you will need to taper off rather than quit all at once.

[johntPM]

The question that elsidwarrior raises is can you notice the effect of a PD drug?

You can estimate the effect of a drug dose by taking into account the dose size and using the pharmacokinetic parameters of that drug.

(Pharmacokinetics: what the body does to the drug; pharmacodynamics what the drug does to the body.)

Since the most used drug to fight the symptoms of PD is levodopa (usually with carbidopa or benserazide) it makes sense to convert the doses into levodopa. Note that this is just a mathematical model, you don't at this stage, at least, convert the drugs. In this case, research shows that 1mg of rotigotine patch is worth about 30 mg of levodopa/carbidopa. This is called the levodopa equivalent dose (LED). Note that rotigotine is a dopamine agonist, it is not levodopa, rather, it has, in some sense, equivalent effects.

In a day you might have, typically 4 doses each containing 100 mg of levodopa but only one patch. The levodopa drug gives a total during the day of 4 x 100 = 400 LED. The 4 mg of rotigotine 30 x 4 x 1 = 120 LED. The levodopa dose is higher so it is more likely to be noticed by the patient.

But, a more detailed analysis is possible, taking into acount the absorption and metabolism of the drugs. The rotigotine patch lasts all day. So the 120 mg LED is spread out over 24 hours, giving 5 mg / hour. There is something close to steady state. Whereas, the levodopa dose has an impact that is cyclic, going from little to a maximum (TMAX=60 minutes) before declining rapidly (THALF=90 minutes). The graph is a saw tooth. You notice this as "on" and "off" periods.

You may be interested in an app that I wrote some time ago to do this analysis. You enter the doses of each of the drugs in your regimen and it draws graphs showing the contribution made by each of your doses during the day.

parkinsonsmeasurement.org/t...

[elsidwarrior in reply to johntPM]

thanks for reply -