Mirapex is a dopamine agonist and research substantiates that agonists can and do commonly cause hallucinations. This is the main reason why elderly people with PD are not prescribed agonists.

Your hub is over medicated. Most neuros want us young pwp to be on as high a of dose agonist and low a dose of Sinemet as possible. The meds are all self trial and error.

Given that the agonist is more likely the culprit based on research and patient confirmation, I would target the Mirapex first. Is there a reason why your doctor is band aiding the psychosis rather than ridding of it by slowly lowering dopa drugs? Is that mix optimal for his motor symptoms? We develop tolerance to both drugs and they do set off addictive type behaviors in some patients. The agonists in particular can cause withdrawal symptoms. It is very important that meds are not stopped abruptly. As a nurse you may know this, but doing that can cause a life threatening condition called Neuroleptic Malignant Syndrome.

In my experience one can be totally over medicated and not know it due to tolerance. I went from 12 mg of Requip to 8 mg in two months; actually felt better, and my PD symptoms were no worse. I also take Sinemet. I have had the same med combo as your hub and at half his levodopa dose and I was bouncing off the walls, so I cannot imagine what you are both going through right now.

If your hub really needs the agonist too then you could always ask doctor for an extended release version because there would be a more regulated receptor stimulation and then likely no voices.

Please update us!

Laura