Having no success with, alleviate symptoms (mainly tremor), with sinemet, amantadine , ropinirole I am moving to Neupro patch, 4mg, on Monday. My cost will be $350. I hope the cost is a reflection of its effective treatment for reducing my tremor. (and other symptoms)
The tremors were so terrible one night this week, and painful arm and legs, I am willing to spend.
As they say, if the Parkinson's med works, it is a sure sign you have Parkinson's. As these drugs have no effect in my case, maybe I do not have Parkinson's.
It is common for someone to appear not to respond to levodopa until a threshold is crossed. This threshold varies from person to person, and depends on things such as how much dopamine your body still produces and how much of the levodopa gets to the brain.
Sometimes you can get an early warning that the levodopa is having an effect by using:
This program measures how many times you can type q followed by p in 30 seconds. There is a definite training effect - you get better with practice - so run it at least 10 times to get your eye in. Then, do it before you take a dose of levodopa and again 60 minutes after the dose. Is there any difference?
Assuming that you're on nothing else yet, and it's some time since you've been diagnosed, a daily dose of 300mg of levodopa in C/L can easily be "lost" - especially if you take it with food - not getting you to the threshold. It varies from person to person, but a typical figure might be 800mg per day.
As I understand it, to a first approximation, the doses with a scaling factor applied of the different Parkinson's drugs are additive. You can work out a Levodopa Equivalent Daily Dose. Mine is 760mg (5x75mg Stalevo = 500, 1x8mg ropinirole CR =160, 1x1mg rasagiline=100).
Regarding tremors, I know this won't be the same for everyone, but I find my tremors reduce when the levodopa kicks in, about 45 - 60 minutes after the dose.
I have been on the Neuro patch now for two weeks. Helps some of the tremors but still dealing with the nausea most of the day. I put the patch on just before I get in bed. You are right about the cost. Mine was $260 with insurance (Silver Script). I will stay with in for the next two weeks and then look around for a cheaper drugstore. Good luck and let us know your experience with the patch. Wil
No nausea. No noticeable reduction of daytime tremor, but oddly less tremor at night and I was able to sleep through most of last night. Needs more observation.
Needs more observation. On 4m patch and will soon move to 6m.
Still sleeping better but hip and leg pain a bother. Taking gabapentin for that issue.
I asked my GP / family doc to move the prescription to 8m but he wants me to titrate to six before eight.
I am judging the effect of med by how my tremor changes, not my balance. Tremor is my priority. Seems less tremor at night. No recent "attacks of severe tremor and arm pain". Hoping that is due to the med.
Of course its the medicine helping and good to hear that it is! Your doctor is right to titrate you slowly. All pd drugs take time for our body to adjust to them and especially agonist meds..
I suspect the other drugs you have tried would work too but you werent on the right dose. It seems that people who delay taking meds end up needing the equivalent dose to what they would be on if they started early. It can take quite a while to get sorted on a regime.
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Neupro side effects
Nicotine patches vs gum. 
Did your external tremors 'start' as internal tremors?
