Rotigotine/Neupro patches causing deep drowsiness after food

[Jefferami]

I've recently been ramping up to my current 8mg of neupro. However now I'm noticing that an hour after any significant food I get a deep sleepiness to the point I'm almost asleep on the spot. Any one else get this? Is this just temporary? Think it's all food but maybe others found its certain things? Not on any other significant medication. Thanks

[park_bear]

This may be postprandial hypotension. Check your blood pressure when this drowsiness occurs.

Is there a reason why you are taking a substantial dose of a dopamine agonist and no levodopa?

[Jefferami in reply to park_bear]

Hey, difficult to check but will see what I can do thanks. I'm on a trial recommended by my MDS. My guess is that at my next appointment in a few months I will be adding levodopa.

[park_bear in reply to Jefferami]

Dopamine agonists have their place but in my opinion should not be the first line medication for treating Parkinson's in place of levodopa. The reason for this is they have more serious adverse effects - 50% of dopamine agonist users suffer impulse control disorders within 5 years of commencing treatment. Impulse control disorders include, among other things, compulsive gambling. Some seniors have lost their retirement as a result. Your doctor should have warned you to be on the lookout for this, and is negligent if he or she did not do so. Orthostatic hypotension - loss of blood pressure upon standing - is also pretty common.

Based on your post it seems that the dopamine agonist is causing the problem you are experiencing. My recommendation is to call the doctor's office and to request to be switched from your current regimen to a levodopa medication. Note that dopamine agonist medication must not be stopped abruptly, but tapered over time.

reference: pubmed.ncbi.nlm.nih.gov/299...

[Jefferami in reply to park_bear]

Interesting. According to my MDS acting out happens in 6% for neupro and around 15 to 20% in ropinerole. Apart from high levels of drowsiness and now insomnia I've had few adverse effects.

[park_bear in reply to Jefferami]

Incidence of impulse control disorder increases over time. Something to be aware of. If you have a partner, good to discuss with them in order to help you maintain awareness.

[Hikoi]

dopamine agonists are know to cause sleep attacks. My classics are falling asleep momentarily whilst in the middle of a conversation and falling asleep in a hair dressers chair then vomiting everywhere while still ‘asleep’. You wouldn’t want to be driving until this is sorted.

I suspect you could be describing peak dose effect, though I also have times I cant keep my eyes open after lunch. Usually it improves with time as your body adjusts.

[Manou38 in reply to Hikoi]

J'ai un patch neupro 8mg et pas de problème.

[Parkie1]

Morning..I started on Neupro 6 months ago in addition to Madopar, which I've been on for almost 5 years. The reason given Neupro was to even out the "offs" from the levadopa doses, which it has slightly helped, but I am only taking 4 mgs. I was well warned of the side effects mentioned by the others here, & had to sign a disclaimer. I too fall asleep after dinner but I did so before taking the drug! Just sleepier now all evening. For that reason I'm not willing to raise the dose to my recommended 6mg, because I don't want to loose my driving licence if it were to make me even more inclined to drop off to sleep , but it helps me sleep at night which is why I continue with it. I agree that you need some levadopa with it. If you come off it it has to be very slowly titrated.

[Jefferami in reply to Parkie1]

Thanks for that. I take mine in the morning , when do you take yours? I'm wondering if it makes a difference?

[Parkie1 in reply to Jefferami]

I also take in the morning. Started at 7:00am then gradually to 10;00 am . Inconvenient at times ,but it does help delay the affect a little.

[Jefferami in reply to Parkie1]

Thanks. I was wondering if taking it say 7pm would be better. Could I ask why you take late morning and not evening? My MDS I think wants to limit my levodopa by supplementing with neupro first then I'm guessing introducing it next. Strange but he's one of the best I'm told in the field.

[Parkie1 in reply to Jefferami]

Late morning to put back the sleepiness which develops through the day.....seems to peak late evening

[6daniparky]

Mio marito ha sospeso Neupro per orticaria, ma tutti i farmaci per il Parkinson, levodopa compresa, gli danno sonnolenza. La situazione è precipitata wiando ha cominciato Ongentys oltre a Xadago e Madopar. Dormiva anche in piedi e aveva allucinazioni. Tolto Ongentys, più rigido, ma piu lucido e sveglio!'

[ccr69]

I only take Xadago one in the morning and Madopar 125 four tabs split over five doses, 6am, 9am,12noon,3pm and 6pm and I get the same drowsiness you describe. I get this after every meal to the extent that I fall asleep at the table. I would appreciate any comments. Up until reading your comments , I hadn't joined the dots and realised that my drowsiness after every meal could be linked to my Parkinson's meds.

[Jefferami]

Just to add to this after a few months. I went down to 6mg of neupro and 100mg levodopa and now those sleep and fatigue periods are virtually gone. Also my sleep is better through 6mg of melatonin. Finally I take my neupro just before bedtime. Things are much better of energy and sleep now.