Hi everyone,

I am looking for some advice or personl experiences regarding dopamine agonists.

Tried requip - side effects, sleepy, not quite with it.
Tried rotigitine patches - side effects, very ott, compulsive behaviour.
Currently on pramipexole - side effects, very compulsive behaviour, gambling etc.

Due to see the parkinson's nurse tomorrow so looking for some information on other dopamine agonists that readers have found suitable with minimal side effects, namely the compulsive behaviours.

I worry that there isn't a suitable replacement.

The main problem with just taking the stalevo on its own is the agitated feeling, any advice on this would be good too.

Many thanks in advance,

DLH.

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Hi.

You've probably read my story, and know that I can't take any kind of DA.

However I'm now taking a combination of Stalevo, Sinemet CR, Gabapentin & Azilect. I'm about to add Madopar to the concoction.

I also take an antidepressant (Citalopram), painkillers (Solpadol) and assorted vitamins & minerals.

There is no reason why you need a DA at all. Thousands of us are perfectly happy with a purely L-Dopa solution.

Ray.

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Minimal side effects,suitable alternatives,I wish drug utopia,but one day we will get there im sure
Pd meds are a lucky bag Have you ever thought ,that every patient that your neuro sees at his clinic is different,I am sure that no two people come out of the consulting room with the same medication prescribed. PD it has similarities and yet a uniqueness in everyone who has it and why We all should have a management plan.A diary as a short term strategy whatever suits you It helps focus.and manage
Expect to improve and expect side effects.Side effects if you are lucky maybe a storm in a teacup, its sometimes neccessary to take other meds to help you through till your body adjusts in its own time and remember as you increase meds those side effects return and depart again for some.
I dont think 3 months is long in adjustment terms when changing or begining a new regime,they are after all majorly tweeking you brain chemistry.If you have to slow changes up and down cause less chemical mayhem be patient Im not,but in the battle with PD I have to be,remember also that side effects can make PD symptoms worse ,dont assume that you are worse ,stay at the same level or reduce and up slowly again if needs be at a pace your body is happy with If side effects are harmful in there impact on your physical or mental health,there maybe no option other than reduce or remove
pills are like juggling balls sometimes I take with food to avoid nausea sometimes before food to maximise the dopa in the tank Ifs and buts .Always seek advice but your imput how you feel is the issue understanding a great medicine in itself.

Where do i go from here?

Went to see parkinson nurse, now on, 150mg stalevo 4 daily, sinemet cr 25mg (i think) x 2 nightly, two sleeping pills 20mg each, although they are really anti-depressants, so not sure about that one! Seem to be sleeping better, not up every hour or so so a good start, but not functioning as well just on these tablets, much better on DA's, but mega side effects, hence change, anyway, does anyone know if there are any compulsive effects from the drugs listed above or is it just associated with the DA's???

Dopamine Agonists:

Apokyn
Apomorphine
Bromocriptine
Cabaser
Cabergoline
Dostinex
Lysuride
Mirapex
Mirapex ER
Neupro
Parlodel
Pergolide
Piribedil
Pramopexole
Requip
Requip XL
Ropinirole
Rotigotine

Entacapone, one of the components of Stalevo, is NOT a dopamine agonist, but some patients DO nevertheless experience compulsive behaviour (hypersexuality, gambling, etc) when taking it.

The patient notes for Entacapone DO warn about this risk, so if you are susceptible you need to talk to your PD nurse or consultant about finding an alternative solution which doesn't involve Stalevo or Entacapone - possibly Madopar.

Sometimes Entacapone is taken separately, alongside Sinemet Plus maybe, but the same warning applies.

Thanks Ray of Sunshine, that's some list! Really really helpful, maybe it's the added ingredient in the Stalevo, will google on the net for some more info, had absolutely no idea.

DLH.

list looks longer than it is in reality as several drugs are there under different names, like Dostinex=Cabaser=Cabergoline or some (Piribedil, Lisuride)are not licensed in UK.

Agreed, but if people want to just skim down a list to see if their medication is (or was) a DA, it's probably best to list each drug in all its known identities.

Have decided that the stalevo 150mg are not working, tired and foggy headed, thought i would drop the dose back to the 100mg as they seemed to work ok, but now reverted back to the sinemet, much more mobile and 'with it'.

Good news DLH, well done!