Rasagiline/Azilect?

[ghoegap]

Hi ! My hwp (77) diagnosed 2017. But of course with hindsight symptoms manifested earlier. Started C/L last year : 25/100 @ 3 times a day. Azilect 1 mg once a day . Walking became a really serious problem a month ago. Partly because of ongoing "sciatica" but also freezing a few times a day. Two weeks ago dizziness which might be due to orthostatic hypotension. Occurred the first time after floor exercises. Seeing the neuro in 10 days time. However, checking through the meds it seems as if the azilect/rasagaline can cause the hypotension. He has tremor bilaterally but unless stressed the tremor is certainly noticeable but not a huge issue. The recent worsening of the walking, feeling unsteady, favouring the painful leg, not being able to walk any distance at all without having to sit ( not from fatigue but because of pain) has been so sudden and so marked . We feel to ask for an increase in c/l ? Until maybe 5 months ago my hwp was able to walk very far and that was for him such a pleasure. Then this off and on sciatic pain became debilitating. He sees a physio that specialises in movement disorders, exercises with a group under her supervision but here we are , walking is possible but only just so. He uses a rowing machine now, does stretches etc and generally speaking goes about the business of his life despite the present hardship. Stack includes: fish oil, B1( have never hit a sweet spot with that) PEA, stopped cinnamon recently because of sudden edema in feet, B12 oral spray, calciferol, vit c powder. Any input, advice will be appreciated.

[park_bear]

Sciatica is usually caused by deterioration of an intervertebral lumbar disc, resulting in impingement upon the sciatic nerve. Fish oil has been shown to help these discs regenerate. I recovered from sciatica using a high fish oil diet. My writing on the subject here: tinyurl.com/27b3ahw7

Since he is already using fish oil, perhaps more or different fish oil would help.

[ghoegap in reply to park_bear]

Thanks PB we have tried every single thing we were told about, will up the dosage . I am very interested in The Pain Revolution see Lorimer Mosely. But Parkinson's muddies the water

[Allypally49]

My WWP, was put on 1mg of Rasagiline about 18 months ago, from the MDD whom she has never had a 1:1 with.I read over a year ago that Rasagiline increases dyskinesia,

A year ago I mentioned it to the MDD but she wished to keep it going due to cramp pain in her leg calf area.

I then read that Rasagiline should be prescribed at 0.5mg and if it doesn't have any effect, increase it to a MAX of 1mg.

I've no ideas why the above procedure wasn't used firstly.

[Dabaa in reply to Allypally49]

Hi. I've just been prescribed it at a starting dose of 1mg so am a bit concerned. Do you happen to have the reference link to the 0.5mg info please? Thanks and best to you.

[Allypally49 in reply to Dabaa]

Is it to be taken with or without levodopa?

[Allypally49 in reply to Allypally49]

1mg without levodopa 0.5mg with levodopa

mayoclinic.org/drugs-supple...

[Dabaa in reply to Allypally49]

Thank you so much. Appreciated. (With).

[Agnes1234]

Probably needs a MRI and/or nerve conduction study for the "sciatica" to rule out lumbar/sacral issues. Totally possible to have a non-Parkinson's problem!

[Specterishot]

Google a McKenzie certified physical therapist for a scientific specific exercise program.. There is a directory. This is a PT intervention to reduce disc pressure and alleviate sciatica. It works ...if u comply 100 percent. Every other sciatica treatment is just trial and error. This is tailored specifically for your husbands symptoms and his response to the McKenzie Exercises they prescribe for him. Getting rid of the sciatica is priority here!!Also I feel 25/100 3x a day of C /L is too low if he can't walk well due to the Parkinsons. Consider increasing slowly by a half a pill especially before trying to walk or exercise. My pwp walks better on an extra half pill than on just one 25/100. Call your MD first to clear it, but I find u have to experiment a bit with CL to see for yourself how much it helps the symptoms. A half a minute walk down the hall at the Neurologists office seems a very poor way for the doctor to decide the correct dose to improve gait( his main symptom). MY PWP main symptom is slow, slightly shuffling and stiff gait. He takes 1 pill and a half of CL twice a day and just one at 8pm. His gait is better but still not normal. We r considering increasing to 2 pills a day, as I understand dyskinisia is much less common in folks diagnosed after age 65. My husband was diagnosed in 2021 at age 74. We r also close to starting a high dose B1 trial. We r doing fast walking, wt training, stretching, and boxing a bit of Tai Chi and supplements. The movement disorder specialist thus far has given us almost no guidance. So research as much as u can, use this site and take your best shot at what complimentary treatments/ dietary changes you are comfortable adding.

Confident the McKenzie system fixes his sciatica issue.

Good luck. Finding the right balance with PD is quite complex!

[ghoegap in reply to Specterishot]

Thank you! Will investigate. The C/L plan makes sense to me. This site has meant a lot to us over the years . We are new the C/l though, only been using since middle of last year. I am far warier of trying supplements etc these days. One gets excited by news of something new, you get crosseyed from reading studies ( thank goodness for people like PB and Chartist etc who can better interpret the info) . Very grateful for advice on the C/L , we are newbies with that. Every good wish

[rleedc]

Your husband should see a chiropractor. Yes, an MRI is advisable to rule out other causes of sciatica such as disc herniation. Many times sciatica can be caused by the tightening of the Piriformis muscle. The piriformis many times tightens due to misalignment of the opposite side SI joint. Correction of this sacroiliac problem can alleviate sciatica in many cases.