they do test new agonists againt old ones and carbidopa/levodopa.
some people do just fine on mirapex and requip , but some people can't tolerate either. i think the side affects are clearly stated on the package insert.

i know a few who do very well on requip and mirapex, one person i know on 4.5mg of mirapex is in incredible shape, she went to a 90 minute spinning class on thanksgiving day and prepared dinner for 19 people. most pd'ers i know who are doing ok on their drug regime don't read this board. not knocking it, just saying you can't take everything as gospel.

but some people can't tolerate either. i think the side affects are clearly stated on the package insert.

you have to remember that many people doing ok with their drug regimes don't read these boards.

i always suggest someone get THE PARKINSON'S DISEASE TREATMENT BOOK by AHLSKOG or another general book on pd and learn about the drug treatment strategies.

trying azilect or an agonist first still seems the conventional thinking, figuring out the best pd meds is an art more than a science, everyone is different.

i'd trust your neuro, if you don't then get a second opinion.

there is the PATIENTSLIKEME website which tabulates pd'ers opinion about different drugs.

Thanks for the comments...I have Alskog's book, and it is great but he doesnt say much about the multitude of Mirapex side effects - e.g I suddently got so many new 'floaters' in my visual field it scared me. I also am on Patients Like Me, and found their compiled stats on Mirapex, and thought I had a good chance of doing well on it. I appreciate the Soccertese comment about 'silent' people doing well who do not post on this or other sites, so the info. may be skewed, but I forget that when I am reading comments, so thanks for reminding me. SB

Sarah
Did you take medication for nausea each day and did you increase your dose very slowly? I haven't tried Mirapex but have been on Ropinerole for 5years. It took some months for me to slowly work up to the right dose.

I think agonists are tough meds to get used to but i find Ropinerole helpful particularly relieving stiffness and making movement easier. I haven't heard from my Parkinson friends that they find one agonist is any better than another. I do have friends who have been on Ropinerole and have found it difficult to get off the drug and I have read about the Dopamine Agonist Withdrawal Syndrome but only in the context of withdrawing after long term agonist use.

Head to head pramipexole V ropinirole: recollection loss.

Unfortunately behind a pay wall, but in the Abstract Shepherd et al. write [1]:

"Recognition memory (RM), familiarity, and recollection were examined in 21 patients with mild-to-moderate PD ... Patients were subdivided into two subgroups according to dopamine agonist (pramipexole [PPX] or ropinirole [RPR]), and completed matched versions of an RM test in a medicated and unmedicated condition ,.. Ten demographically matched healthy volunteers (HVs) also completed both RM tasks in two separate sessions. The PD group (PPX and RPR subgroups combined) showed impairments in RM and recollection, but spared familiarity. When subdivided by dopamine agonist, the PPX subgroup's ON-medication recollection performance was significantly lower than that of both the HVs and RPR subgroup. There was no evidence of decline in OFF-medication recollection or familiarity in either the PPX or RPR subgroups."

Note the small sample size, but the good news: some of the memory loss shown by PwP is likely to be due to the medication, rather than the disease itself.

Reference

[1] "Second-generation dopamine agonists and recollection impairments in Parkinson's disease"
Thomas A. Shepherd, Nicola M. J. Edelsty, Andrew R. Mayes, Simon J. Ellis
Journal of Neuropsychology, 7.2, Sept, 2013
http://onlinelibrary.wiley.com/doi/1...12025/abstract

John