Medication for symptomatic thereapies

Posted: Sun Sep 09, 2007 3:09 pm Post subject: Medication for Symptomatic Therapies


I understand there are now two groups of medications at replacing the dopamine deficiency in the brain of treatment.

There are dopamine agonists and levodopa. As a doctor which are you prefer ? What's effective in treating the symptoms of the disease? Which one are more applicable for younger patient and the older patient or both?

I understand Levodopa is the "wonder-drug" and has been associated with "wearing off" and dyskinesias. The dopamine agonists started at a low dose and increased gradually to avoid side effects that include nausea, vomiting and giddiness on standing.Is it true? What's the reason why some patient start either one agonise and later with both?

I am taking Levodopa i,e. Sinemet 25/100 one dose three times per day and one Jumex 5gm one dose two times per day for 2 years.

Dr. Chew Nee Kong my doctor recently starting me with Requip at low dose and increased gradually to 12 gm with two dose of Sinemet 25/100 to optimize the medication.

My two personnel trainers are surprised that my agility improving by 90% and pleased with my mobility and flexibility. I can do standing tree posture in Yoga. I do not feel tired whilst spending 3 hours gym
classes in the gym centre from Mon to Friday. I do two body massages on every Wed and Saturday to loosen my muscles.

TEOKIMHOE

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Kathrynne Holden, MS, RD



Joined: 22 Jan 2007
Posts: 94
Location: www.nutritionucanlivewith.com
Posted: Sat Sep 08, 2007 4:59 pm Post subject:

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Dear Teo,
I am not a doctor, but a registered dietitian; advice regarding medication is outside my scope of practice. I can comment that in general, the agonists are preferred for younger patients, and that some older patients do not do well on them.

I will move your question to "Ask the Doctor." Drs. Okun, Rodriguez, and Fernandez are excellent PD specialists and highly qualified to respond to your concerns.
_________________
Best regards,
Kathrynne Holden, MS, RD
--
For a Parkinson Tip of the Day visit:
http://www.nutritionucanlivewith.com/

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Dr. Fernandez



Joined: 20 Jan 2007
Posts: 90

Posted: Tue Sep 11, 2007 8:21 pm Post subject:

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Deciding which drug to use first in a PD patient is not a one-size-fits-all thing.

In patients who are older or who have more significant symptoms we tend to use sinemet. This is because older patients are less likely to develop motor fluctuations (especially dyskinesias) from sinemet. As for why we use sinemet for more significant symptoms, this is because sinemet is the most efficacious drug there is to date.

In patients who are younger or those who have milder disease, we can start with dopamine agonists such as ropinirole or pramipexole or MAO-inhibitors such as rasagiline. Some may even start with amantadine.

It really all depends on the situation.

Yours,
_________________
Hubert H. Fernandez

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