I was just discussing my prescriptions with my mail order pharmacy and trying to see if I could save money by having more of my prescriptions filled through mail order. I typically have my Venlafaxine(Effexor) filled at my local pharmacy, but now that I have been on it for awhile and don't need to tinker with the dosage anymore, I thought it would be less expensive to get that through mail order as well. I just started on the Azilect a month ago and I have been using samples from my doctors office. I was talking to the mail order pharmacist about whether or not the Azilect was covered under my plan. It is covered, but she said that it isn't recommended to take Azilect and Effexor together because of a possible interaction. My neuro is aware that I am taking Effexor, but didn't mention any possible interaction. The pharmacist was very concerned. She told me some of the symptoms of the possible interaction. They are things that I mentioned to the MA when she checked me in at my last appointment. My blood pressure was a little higher than normal and my pulse was higher as well. It has been around 100 at rest when I check it. I also was concerned with having the sweats. My face and upper body will get so sweaty at times throughout the day. I mentioned all of that when I was checked in at my last appointment. I called my Neuro's office and left a message for him. I spoke with the same MA that had checked me in at my last appointment. She remembered me discussing those things with her. She is going to let the doctor know and somebody will get back to me. Has this happened with anybody else?

I have heard that it is hell getting off of Effexor. That is a little concerning to me. I am willing to go off and try a different anti depressant. Honestly, the Effexor hasn't been all that great. I feel less depressed, but I have more of an emotionally flat feeling than anything else. I would love to find a medication that makes me actually able to feel really HAPPY. Maybe this med change will give me that opportunity.

I know that rather than changing my antidepressant, I could choose to drop the Azilect. I would rather stay on the Azilect because of the possibility of neuroprotection. I am going to be 35 on Saturday. I have a long time to deal with PD and I want to keep as much of my dopamine around as possible.

Any advice or stories to share? Prayers would be appreciated. This kind of stuff just makes my head hurt!

Thanks,

Evonne

Serotonin Syndrome can be caused by taking a MAOI and SNRI together. It can even be caused by taking either of these types of meds alone. Here is a link for more information.
http://en.wikipedia.org/wiki/Serotonin_syndrome

It is always wise to research drug interactions, when we are taking Inhibitor type medications

I constantly have to remind myself to be aware of certain OTC medications that I buy without thinking about it

Im taking Stalevo, and check out the list of meds that interact with Entacapone, which is a COMT inhibitor


entacapone-oral (cont.)



DRUG INTERACTIONS: Tell your doctor of all prescription and nonprescription medication you may use, especially of: most MAO inhibitors (e.g., furazolidone, linezolid, moclobemide, phenelzine, procarbazine), isoproterenol, adrenalin (epinephrine), norepinephrine, dopamine, dobutamine, alpha-methyldopa, apomorphine, isoetharine, bitolterol, probenecid, cholestyramine, certain antibiotics (e.g., erythromycin, ampicillin, rifamin, chloramphenicol). According to the manufacturer, if you are prescribed the MAO inhibitor selegiline you may continue to take it while using entacapone. Also, report use of any medicine that can make you drowsy, such as: sedatives, tranquilizers, anti-anxiety medicine, anti-seizure drugs, narcotic pain relievers (e.g., codeine), psychiatric medicines, certain drowsiness-causing antihistamines (e.g., diphenhydramine). Do not start or stop any medicine without doctor or pharmacist approval.

http://www.medicinenet.com/entacapone-oral/page2.htm

I noticed that your list mentioned Levodopa. So, does that mean that you can't take Sinemet? I love the idea of taking something neuroportective like Azilect. I think that the thing that concerns me the most is that there seem to be a lot of things that interact with it. Anesthesia is one of them. What happens if you need to have emergency surgery or something? I guess all we can do is let the doctors know what we take and then it's up to them to figure out the rest!

I am really surprised that I still haven't heard back from my neurologist. He recently came back from vacation, so I guess he must be really slammed at the office. Still, I would think that in a situation like this, at least the MA would call me back. I didn't take the Azilect today. I am still taking the Effexor until I hear otherwise. Thanks for your response, Steve!

Evonne

Yeah, I saw that..It says "dopamine"..not sure if they are refering to levadopa or not, because Stalevo is a combination of entacapone and levadopa..That wouldnt make sense

Which now that I think about it, I got desperate one day and tried some Mucuna powder, and what that is, is herbal dopamine..I dont remember if I was taking Stalevo at the time..But now that I think about it, maybe that had something to do with, why I coudnt get up off the floor when it wore off


Anesthesia?..Wow, that's not good..I wonder if there is an alternative Anesthesia drug?..In either case, it would be important for the hospital to know about that..Its hard enough to get the message across when you're conscious, never mind unconscious, and in an emergency situation

I am thinking about ordering a vinyl bracelet with my medical information on it. You know, the kind people wear for cancer and other things. I think Lance Armstrong's Live Strong Bracelets have probably been seen by everybody. I found a site on-line awhile ago where you can order the medical bracelets. You can have them customized so that the part that actually faces towards your arm has all of the personal/medication information. The outside, in my case, would say Insulin Dependent Diabetic/PD. The inside would list all meds. I am going to put a card in my wallet with my driver's license listing all of this stuff as well. It might be awhile before I order the bracelet. I have to get all the meds straight first.

Steve,
Bummer about winding up on the floor! Probably had to do with that Mucuna! Yikes!!! How are you doing now with your meds? Well, I better get a move on. Gotta get ready for work. This has been a long week and I am looking forward to the weekend!
Hugs,
Evonne

I have been on effexor before. Actually been on many types, when one stops working, I switch to a different one. I have always decreased the dosage slowly when switching antidepressants. I did not have problems at all with getting off effexor. Everyone is different so reading that one person had a hard time getting off it does not mean you will, even tho I know it must make you worry.
I think they are cycling thru vacations at your neuros office by the way.

I went through a tough patch, that lasted for about 6 months..CR wasnt working anymore, and I began having terrible off periods, or atleast that is what they seemed to be, so my neuro gave me some Stalevo 200's, about 6 weeks worth..It worked great, but when I was running out of them, I put in my Rx to CVS, and my Part D insurance company, rejected the Rx, and said that I had to try Comtan with my generic CR first..So I did..I never got dyskinesia untill I did that..I got worse as a result, alot worse..So I called my neuro, and asked him if he had anymore samples of Stalevo, so he gave me some, but they werent 200's..They were 150's and 125's..That didnt work either, so I got desperate and tried the Macuna powder..I have never taken anything for pd, that worked as good as that stuff..But the problem with it was when it was kicking in, I would get a jolt of dyskinesia, that lasted for about 20 minutes, and then almost no symptoms whatsoever for about 4 hours, untill it started to wear off..With very little warning, I got a dyskinetic twitch in my right leg, and the Macuna wore off so abruptly, that it was like getting thrown off a building..I went from no symptoms, to worse than unmedicated pd, in a few minutes, so I stopped taking it

Anyway, my neuro told my insurance company that the Comtan and generic CR didnt work for me, and finally the insurance approved the Stalevo, and since then, Ive been back to my old self again

During that 6 month period, I went through a number of med changes..From Generic CR to Stalevo, to Comtan and generic CR, to brand name Sinemet and Comtan, to generic Sinemet 25/100, then back to Stalevo..In retorospect, it seems that when all the levadopa/carbidopa products that I ingested, either alone, or mixed with Comtan stopped working, all I got daily, was very limited on time, and the rest of the day consisted of nothing but side effects from the medication..Seems like the Sinemet, etc actually made me worse

I talked to my Neurologist today on the phone. I told him that two pharmacists told me about a dangerous interaction between the Effexor ER and Azilect. I asked him about whether or not it is safe to take my Effexor ER and Azilect together. He told me that the prescribing information states that there is a risk, but that he has never had a patient have a problem with it. He offered to put me in touch with a Pharmacist that he works with in order to have any additional questions answered. I declined. I told him that I trusted his experience and that I appreciated him returning my call. After our discussion, I decided that I am going to continue to use both medications together. I am aware of what the symptoms of the interaction are, so I will be on the lookout for that. He said to let him know if I have any problems.

Libra,

Depression stinks! I have tried multiple depression meds throughout the last seven years with not much success. The problem that I have is they all make me feel kind of flat emotionally. They alleviate the worst depression, but I tend to become a little apathetic. I know that depression is chemical and that a lot of PD patients have problems with antidepressants not working well. I am trying to maintain a positive attitude and remember all of the things that I have in my life to be grateful for. I would give anything to feel the kind of happiness I felt five to seven years ago!

As far as my doctor, I decided to return to my original Neurologist. When the third Neurologist that I saw diagnosed me with Essential tremor and the meds didn't help, I wound up going to my GP. He prescribed Sinemet. Within a couple of days I was able to move my stiff neck. Now, I have totally normal range of motion in my neck. It has made an unbelievable difference. I still have a bit of a fine tremor whenever I move, but it is a result of the cogwheeling. It isn't nearly as bothersome as it was before.

We should try and get together soon. I met another really nice lady in CD'A with PD. She has had DBS and is doing great. We have had lunch together once before and we talk on the phone now pretty regularly. Maybe we can all get together some day. PM me if you are interested.

Steve,

Sheesh. I am so sorry that you had such a rough time of it! I am glad to hear that you were able to get your insurance to cover your meds for you. Insurance companies are so terrible! My mom has terrible acid reflux and has tried all sorts of prescription medications. The one that works for her is called Kapidex. Unfortunately, it is among the most expensive meds. They haven't agreed to pay for it yet. My mom has been on some less expensive meds and has lost weight because she can't eat without feeling sick. Hopefully, after her doctor sees that she has lost weight as a result of not being able to eat, the insurance company will agree to pay for the right medication.

Well, I have to get going. We have to head out the door for soccer practice in a few minutes. Nice chatting with you all again!

Hugs,

Evonne