Yeah! What Steve said!

i recently asked a MDS which agonist had the least side affects and he said NEUPRO.
bottom line, sinemet (carbidopa/levodopa) is the gold standard, not sure if you have tried it but you could do a short trial, 1-2 weeks and see how it does and if it really helps have peace of mind that there is something that works.

issues with neupro are cost, will your insurance pay for it, and skin irritation. it's still an agonist so you'll probably have side affects but because it's transdermal and continuous delivery, you'll be taking a lower dose.

I took Requip XL for years with very few side effects and a great deal of benefit. I was switched to a generic and went south and had to change to a different dopamine agonist. I've been on Neupro now for about half a year, starting at 4 mg and recently switching to 6 mg. I have almost no side effects other than a slight skin irritation when I remove the patch. I have never tried l-dopa. The other side effect of Neupro, of course, is in my wallet. I'm sure that my constant cycling enhances the effects of any medication.

I'm not wishing to dispute with others the pros and cons of ropinirole; their experiences are valid for them.

My experiences over the last 5 years with ropinirole (the slow release version Requip XL to be precise) have been positive. I titrated up to 16mg per day over the course of 8 months. I have stayed there ever since, but with other drugs being added.

The thing it does best for me is to keep my "offs" relatively shallow. For instance, I can always walk home without a problem. Also, according to the nurse specialist who treats me, she would have expected to have seen some dyskenesia by now if I'd been totally treated with levodopa based drugs. As it is, I have none.

However, the downside of it for me was that it doesn't do the job as effectively as levodopa. So, when 16mg of Requip XL failed to give a reasonable quality of life, I added Stalevo, which has proved more effective.

I suspect that there's a number of different types of PD and within each type people respond differently to any given drug. In this matrix structure I suspect there are areas where ropinirole works and areas where it doesn't.

Has anyone seen any research into who is best on ropinirole?

John