New meds

[joe45]

Hi does anyone know what ever new med you start taking does it have a settle down period for ur body to adjust,?

Thanks joe 43

[grey]

Hi Joe,

Nearest I can think of is check doseage on individual Meds. Initial doseage and titration rates give a clue to what you ask, but don't specifically answer your question. Reading patient leaflet and also try

Http://rxlist.com

[joe45 in reply to grey]

Hi grey,

Oh that's ok ive read leaflet i just wondered if with all meds they all need time to settle down , im currently on 4mg neupropatch, madopar 50mg , 15mg citalopram for anxiety, and now been put on entacapone for the wearing off which has got less thankfully ....

[grey in reply to joe45]

I've had the luxury of trying all these apart from entacapone. I was offered it, but at that time suffering unrelated bowel problems, so declined the offer. I do remeber my neurologist warning that about 1 in 10 go through a rather unpleasant experience at I think was about six weeks in, rather similar to food poisin. It lasts for a short time and never reoccurs.

It works by inhibiting COMT which converts some LDOPA before the blood brain barrier, thus inhibiting the action of COMT allows more LDOPA to pass through hence more dopamine is avaiable.

Usual get out clause, I'm a patient willing to share my limited knowledge and experience but give no advice.

[joe45 in reply to grey]

Hi gray thanks for reply I hope I dont experience that sounds not pleasent , lucky enough ive not had too much side effects

[grey in reply to joe45]

I don't want to put you off as you obviously are gaining benefit from the product. I think that doctors should warn their patients so that if they are the unlucky person they won't need to worry why it's happening and know it's not going to last long! Ever onwards!

[soup]

Annoyingly Joe, it all depends on the drug and the person.

Some drugs, like antidepressants will take quite a while for the effect to be noticed. Some will take a few doses to have their intended effect but might take a while for your body to stop feeling queasy when you take them. I think Sinnemet and Madopar are like that.

A phone call to your Parkinson's nurse might be useful if you think things aren't going the way you expected.

[joe45 in reply to soup]

Thanks soup i txt her yesterday so should get reply today

Happy new year

[grey in reply to joe45]

You probably already know this, if you are having nausea problems, at titration or other times, then domperidone (Motilium) is a good product to have at the bottom of your medicine chest.

It used to be handed out like smarties, but recently it changed to not to be used long term. You may want to add that to list of items for your nurse to consider.

GP's can find it hard to understand its use by Parkies as it's a dopamine antagonist and therefore attacks dopermine! Okay for Tourette's but rather barmy for PArkinson's. I had resistance from my new GP when I explained it can't get through the blood brain barrier, and I thought he was going to chuck me out when I explained the action on the lower bowel and stomach. He was obviously not used to patients challenging his judgement with a bit of knowledge and I didn't let on that I was only quoting from the patient leaflet!

I'm still registered with him, but always see his junior now. He's more of a challenge as he can use Google and Wikipedia!

[joe45 in reply to soup]

Thanks soup i txt her yesterday so should get reply today

Happy new year

[Pete-1 in reply to soup]

When Levodopa was administered in the early days a lot of it was absorbed into parts of the body where it isn't needed instead of the brain. Also because of this large doses of Levodopa where needed to get enough to help the patient. As Levodopa has a tendency to make one feel rather bilious, having to take a large dose meant you were particularly liable to feel sick

Sinemet has 2 ingredients. 1) Levodopa and 2) Carbidopa. The Carbidopa helps prevent the Levodopa being absorbed until it reaches the brain therefore allowing smaller doses of Levodopa. The name Sinemet comes from sin - meaning without and 2 - emetic. an emetic induces vomiting. Thus Sinemet means "without vomiting. Some people still feel sick so including Carbidopa can't be can't be sure to always work.

Sinemet and Madopar are functionally the same. I take Madopar 125mg 4 x per day. It takes an hour to take effect then works like magic for an hour then there are 2 hours of very variable efficacy. When I first had Madopar I could not tell it was doing anything. That was taking a dose of 62.5mg. When this was doubled to my present dose the effect was profound.

[Hidden in reply to Pete-1]

Has any Noticed a difference between mylan brand & TiVo brand in their carbdopa/levidopa. The TiVo brand makers me so sick & tired,

[joe45]

Thanks soup I txt her yesterday so should get a reply today .

Happy new year!!

[Balderdash]

Hi joe41 not sure if your female but if you are meds can be a problem during the menstrual cycle,they dont work as well mid to end cycle as progesterone and oestrogen levels rise and fall.It was only after several years of pd that that I realised this was the problem and its fixable,there are several options that seem to work well.Hope your PD nurse has helped. I think they are an invaluable intermediary and were lucky to have them in the UK.

[Balderdash]

Just to add Ii think it important to make only one change at a time,to your regime so that you know the culprit if problems arise.Time scales need to be realistic, several weeks to a couple of months is a sensible consideraion The patch has different absorption rates depending were you put it,these can be significant.Never leave a used patch on it still has active ingredients.

[Beckey]

Joe, I have the same question! At an initial very low dose, I had a promising response to zonisamide. However, when I titrate up, the symptoms exacerbate, with the shaking becoming more pronounced and pain in my arm and shoulder socket intensifying. Plus, I'm getting side effects from the zonisamide including sleepiness and nausea. So I'm wondering, should I just tough it out, assuming I will eventually acclimate and get some hoped-for relief? Or decide this is just a trial that didn't work out? What kind of timeline is realistic? I get the feeling when I ask the docs they are guessing...

[Balderdash]

IF your initial response was good, you maybe would benefit from dropping back again.Remember you goal is to get maximum functionality with the minimum medication.

Side effects can overwhelm any benefits to begin with.

I think if you suffer side effects that further impinge on your health you need to stay at that level for several weeks.A Realistic time frame is a minimum of three months to give meds a real chance maximum six to achieve good response