madapar not working

dads been taking levadopa, madapar since two days now. From the first day he took the pills, I can see how 'confused and lost and tired' he looks and seems. Absolutely no improvements in his walking....this is strange ((( maybe we should try azilect now? but ım afraid of using too many pills and meds

[jeffreyn]

Hi Steff,

I've had a look at your posts and replies since you joined, and I must say I'm a bit confused.

Do you think that you could give us a summary of your father's treatment over the last 6 months, so that we can get some idea of the context of your question(s)?

Thanks.

Jeff

[Hidden in reply to jeffreyn]

sure. last year my dad had an MR scan. His walking was slow. His movements were slow. After the MR scan, doctor said he has parkinsons. The doctor prescribed stalevo and madapar to start with but my father only took these pills for 2 months and then dropped all. This year, my dad had another MR scan and doctor examined him again. He said that my father 'may have psp' and said that my father has 'parkinsonism plus with maybe psp'. My father is able to roll eyes up, but not to the extent like I can just to give you an indication. This year the doctor prescribed madapar plus azilect. However my father hasnt taken azilect yet. He has taken madapar for the last 2 or 3 days and yet we see him more confused, more tired and the madapar doesnt seem to be working for him. Yet the doctor had said that he take madapar with azilect together but we were, to be frank, rather unwilling to give him too much meds at once....I am confused :(((((

[Hidden in reply to jeffreyn]

also ı forgot to mention, my father seems to have a worse short term memory this year than last year. He can remmeber the past very well, but the very near past he forgets. for instance he asks me a question then after a few minutes asks me the same question again...this is upsetting for me and for him...so ı wonder if he has MCI also...I dont know

[Pleblanc]

If your dad does indeed have PSP, then these meds will likely provide very little symptom relief. Sadly no meds will.

[Hidden in reply to Pleblanc]

whats worse is that I dont even know if my dad has psp or not...the symptoms of psp is not present in my dad....however, my dad didnt roll his eyes very much upwards to the extent like the doctor can roll his eyes up....but I dont know if that psp or if he has muscles worn out in his eyes or something

[Hidden in reply to Pleblanc]

how would I know if he has psp or not?

[Juliegrace]

MRI is not used to diagnose Parkinson's. I suggest you seek another opinion from another neurologist.

[Hidden in reply to Juliegrace]

The doctor examined my fathers walk and had some test such as eyes and movement tests..he said my father most likely has PD...also this doctor is renowned to be one of the best PD movemet specialist in the country....he said my dad should take the meds and we should observe the situation....but yesterday when ı saw my dad, he seems extremely exhausted and tired and worse than when he wasnt taking any madapar....

[M1tz1 in reply to Hidden]

My husband was on Sinemet, then was changed to Madopar. Both sent him into a deep sleep as if anesthetized.

[Hidden in reply to M1tz1]

I understand you fully...my dad feels seems as though he hasnt slept at all and he seems so totally exhausted and worn out when he takes madapar...its scary for us....ı wonder if this madapar wont work if my dad has atypical Parkinson?

and if it wont work then why does he take the madapar..

[M1tz1 in reply to Hidden]

So sorry he and you are going through this. You're in my prayers. xx

[Hidden in reply to M1tz1]

thank you so much for your kindness , most grateful ,xx

[Jmsbradord]

Hi! I read your post and have seen the replies of others... I would also suggest that you seek a second opinion - and if it is possible, find a Parkinsons specialist!! Very few neurologists actually have any in depth knowledge of Parkinson's. For starters, there are several types of Parkinson's and not all respond well or even at all to Dopamine. How much is your Dad supposed to take? Good luck - fighting the medical establishment is an uphill battle!

[Hidden in reply to Jmsbradord]

Thank you for your reply. the doctor has recommended one tablet azilect each day. and one tablet madapar each day...half madapar in the monrning, and half in the evening

[Motherfather in reply to Hidden]

hi steff well forget the azilect..but your dad should be on at least 1 madopar 3 times a day strenth 200/50 mg.also try him on neupro rotigotine patches, 4 mg/they last 24 hours.who ever is looking after your dad dont know very much.regards

[Hidden in reply to Motherfather]

thank you for your kind reply..ı just wondered why you say forget about the azilect? is it a useless drug_? ı am very much concerend....also the doctor has prescribed madapar...but low döşe of it....what is the rotigotine patches I dont know about that? thank you for your reply

[Motherfather in reply to Hidden]

well steff i have been using azilect for years and it did nothing i have several packets of them in my cubard.i never use..your dad needs the madopar now steff, the patches you can read up on them on google.but the doctor hes using dont know much about pd. just the same as my doctor i told him i had pd..he said no ,now anything i ask for he gives me it as i know more about it than him.

[Hidden in reply to Motherfather]

thank you so much for this, so I should let my dad use madapar..but since two days that hes actually on madapar ı saw that he feels more exhausted and tired and confused as to when he didnt take any madapar so ı had doubt about it

[Motherfather in reply to Hidden]

its very important you up his mardopar steff it will make a differents,

[Hidden in reply to Motherfather]

ok thanks alot ı will do so ..hopefully it Works for him too..thanks

[koshca in reply to Motherfather]

Yes, you right

[Hidden in reply to Motherfather]

they symptoms my dad has is just slowness in movement, and also walking is shuffling...other than that he does not have restless leg syndrome or shakiness etc

[Motherfather in reply to Hidden]

you will see a differents in him if you give him what i said steff dont be afraid as your dad needs help.dont leave it 2 long.

[Hidden in reply to Motherfather]

thank you , ı sure hope so

[koshca in reply to Motherfather]

That's the only way

[Jmsbradord in reply to Jmsbradord]

I would be careful with such high doses before knowing exactly what type of Parkinsons your father suffers from. It is a very small dose, but nevertheless, my mother suffers from atypical parkinsons and large doses like the ones mentioned above were dreadful for her!

[Hidden in reply to Jmsbradord]

yes the doctor did say something like 'atyipical parkinson' to my dad also...but whats strange is that ALL the pills he took we never saw any improvement when hes on them....

[Jmsbradord in reply to Hidden]

Read about it here:

bcm.edu/healthcare/care-cen...

and here:

bcm.edu/healthcare/care-cen...

[Hidden in reply to Jmsbradord]

thank you ı will do so

[Jennyjenny2]

When the Neuro started my husband on Madopar 100/25 he weaned him onto it.

Half tablet at 7am for 5 days

Then next 5 days, 7am half tablet, 11am half tablet

Then next 5 days, 7am half tablet, 11am half tablet, 5pm half tablet

Then next 5 days, 7am whole tab, 11am half tablet, 5pm half tablet

Then next 5 days, 7am whole tab,

11am whole tab, 5pm half tablet

From then on 1 whole tablet 3 times daily, but after 3 days of full dose, after the 11am tablet, he felt terrible...dizzy and felt he couldn't function. So we reduced the 11am dose back to half, as it was only 4 hours between first and second tablets. It took him 3 or 4 weeks from when he started Madopar to feel the benefits, but he also started on antidepressants at the same time, so that could have contributed to his overall feeling. But the point I'm making is maybe consider weaning your dad onto the Madopar.

[Hidden in reply to Jennyjenny2]

thank you, the doctor has recommend half a tablet of madapar in the morning and half in the evening....also he prescribed one tablet azilect in the morning

[andrehypnotic]

What is the antidepressant called?

[Jennyjenny2 in reply to andrehypnotic]

Lexapro 10mg, then increased to 20mg after approx a month. My husband was weaned onto that too...most important to be weaned onto them as he had tried other antidepressants a couple of years ago, full strength straight off, and they made him so much worse.

[Motherfather]

dont be afraid steff the pills wont harm him.or the patches.

[Hidden in reply to Motherfather]

thank you very much,....its just so nerve racking to always doubt the pills..unfortunately ı havent seen any benefits of any pill on my dad...my dad is just slow in his movements and his walking is shuffling and his posture is bent forwards....

[Jmsbradord in reply to Hidden]

Symptoms sound exactly like my mother's... If your doc really is a specialist in PD, go back and talk to the doc and do so over and over...

bcm.edu/healthcare/care-cen...

[Hidden in reply to Jmsbradord]

thank you yes I should do so, infact this is the second moement specialist nurologist that ı have taken my dad to....when ı had said why azilect he had said 'ı have over 35 years of experience are you doubting my decision?' ...so to be frank ı am rather reluctant to ask him any further questions...he said ı should give madapar and azilect..he said my dad most likely has 'parkinsonism plus and maybe trend towards psp' ...ı m really stuck...this doctor is the second one ı have taken dad to...ı keep asking my dad if he feels any better or worse with pills or without ...he says its doesnt make any difference to him...yet when ı look at him ı observe he looks more confused with pills

[jeffreyn]

Hello again Steff,

Thanks for the summary of your father's treatment over the last 6 months. Unfortunately, I'm a bit slow, so I'm still not clear on some points.

In one of your posts/replies you said that about 3 months ago the neurologist changed his medication from Stalevo (3 tablets per day) to Madopar 125 (3 tablets per day). Now you say that the Madopar dosage is half a tablet twice a day. When did the neurologist change the Madopar dosage, and why?

Why did you wait 3 months before trying the Madopar?

In another of your posts/replies, you said that your father is elderly. How old is he exactly?

Thanks.

Jeff

[Hidden in reply to jeffreyn]

Hello again, yes firstly this doctor that I took him to 2 weeks ago is a different doctor from the previous one. The previous nurologist , yes, he had prescirbed madapar and stalevo, but then when he saw no improvements in him, he just said that we should drop the stalevo and should let him take a bigger does of JUST madapar. The doctor increased his döşe of madapar alot and to be frank I thought it was too much of a drastic increase so I couldnt give it to my dad at that time. Also that doctor and I couldnt have a good dialogue communication with each other as he was rather getting angry at me when I raised him so many questsions.

As a result of this, just recently maybe 2 weeks ago or so, I took my dad to another , very well renowned different movement specialist nurologist, who, took a new MRI scan and examined him clinically and yes prescribed madapar PLUS azilect. ..however the döşe of madapar is not as high as the recent formed doctors prescritiion....my father is over 75....and his walking is shuffling, and his movements are slow...sometimes he forgets the very near past but he does remember the past very well.. I just wish he could improve his walking...as when we walk in the park people can see he has problems with his walking and my father wont hold me by my arm when we walk as he wants to seem self sufficient Also, whats worse, is that this doctor that ı just took him to,, he said my dad'may have psp' as my dad coulnt roll his eyes too much upwards vertically...ı think my dad CAN roll his eyes up but not to the EXTENT that my doctor wants him to...so I am yes very confused with all this .

[Hidden in reply to jeffreyn]

this doctor has prescribed one madapar Daily, that is half and half and one full azilect.

however the previous doctor had said my dad should drop the stalevo which he was taking back then, and should switch to three tablets of madapar instead. due to the drastic increase in dosage ı had stopped my dads medication altogther back then and had waited for a certain amount untill taking him to see this second nurologist with whom ı have better diailgoue than with the previous one

[jeffreyn]

Hi Steff,

Thanks for the extra information. Things are clearer now.

Here is my advice:

1. Try not to think about PSP for the next few weeks. The diagnosis is only "possible PSP", and there is really nothing that you can do about it anyway at this stage.

2. Concentrate on the Madopar, and leave the Azilect for later. It is just common sense to not start 2 new drugs at the same time.

3. Since your dad seems to not be doing well on the current dosage (half a tablet twice a day), I suggest you start with an even lower dosage and increase slowly. For example, my neurologist starts new patients on the Madopar 100/25 tablet according to the following schedule:

​--------------Breakfast Lunch Dinner

​1st week: quarter quarter quarter (after meals)

​2nd week: half half half (after meals)

​3rd week: full full full (after meals)

​4th week: full full full (half hour before meals)

​5th week etc: (same as 4th week)

​If at any stage in this process the symptoms disappear, you stay at that dosage. If at any stage in the process significant side effects are experienced, you drop back to the previous dosage and remain there (and contact the neuro).

4. Once the correct dosage of Madopar has been determined, you can add the Azilect. It is quite common to take both Madopar and Azilect, in fact I do it myself (if you click on my name, you can see all my medications, supplements and exercises).

Jeff

[Hidden in reply to jeffreyn]

thank you so much for your kind reply and kind help ..I will sure do as you mentioned..many many thanks for this. I am grateful

[StefHere]

my dad was diagnosed with cancer with he took madapar and azilect together.