Shaking
 

This is toyLs' caregiver.
He has had PD for 16 yrs, 12 of those yrs using sinemet. Now when he takes a dose (one 25/100 SA & one 25/100 reg.), he begins to shake uncontrollably--mostly upper torso--arms/hands/head...really badly...just started 4-5 days ago; getting worse.
The other day he stiffened up and jerked himself out of a chair and backward onto the floor!
Meds include:
45 mg Remron
20 mg Adderall
10mg Vicodin 6x daily, for Degenerative Cervical disc issues
Statin
3mg Valium 3x daily
Also of note--had cervical steroid injection 6/15/12;-seemed to go okay.
Has anyone had any similar experience?
What did your Dr. do?
Many thanks in advance.

Steroids make other meds not work and slow healing. I have back issues, had many of the injections. I take many of the same meds. (vic, statin, valium). Out of all of this steroids stick out to me. Suggest massage, relaxation/meditation and lower stress. I do MUCH better when resting and stopping typing when shaking. So sorry my reply is short, hope it helps.

Suggestions? Try another steroid/cocktail next time; call the doc and TELL him and ask. I'm so sorry to hear this happened.

The Shakes
 

Hi, Do you think this could actually be dyskInesia??
I have had PD for a similar time, 20 years, and I am now incredibly sensitive to L-Dopa. I can only take it in 25mg doses, and no more than 100 to 125mg a day. Even then I writhe and twist for hours. I get 50mg Stavelo tablet and use a pill cutter to halve them to 25mg. I used to need a 100mg to switch me on, but now 25mg not only switches me on, it lasts up to 3 hours, but with bad dyskinesia.
Please give my good wishes to Toyl
Ron

Good call on the dyskinesia...I was assuming you would be familiar with it. Sorry about that. It could very well be. Is there any rocking, hand movement like pill rolling, nausea, vomiting, and dizziness at the same times or immediately preceding the slamming? or any other associated behavior?? I too slammed myself against the couch, hard enough to move it, mostly because I was usually taking refuge there. I hate dyskinesia worse than PD.

Ron do you use ER or CR versions of L-Dopa? (also applicable?? to the orig post-- I shook miserably for 2.5 hours between 3 hour doses. When I stopped the sinemet cr I got much better control. Now I have 2.5-3 hours of no shaking. I discovered this by accident while stepping down doses of sinemet. Part of my issues were totally unpredictable dyskinesia and Dystonia. There was no part of the day that I could reliably make appointments or have "good" time that I could rely on.

I've taken sinemet for 6 years with ER or CR the last 2 years. I discovered this in doing research into (extended release/continual release) tablets. My neuro suggested not using Inderal ER. He gave me regular release and the jump in efficacy was astonishing. So I tried with sinemet and got better results immediately

In reading about l-dopa, sinemet etc it seems that in the package insert (in the tiny print deeply buried, in the bottle and some more science-y sites) that less medicine was available and a total of less metabolized/eliminated during any one time measuring blood/urine concentration. Just by switching off the CR sinemet my doses actually lasted LONGER and symptoms better controlled for longer duration in total.

The dyskinesia totally stopped for the first time in years when I did that. I also had to down dose. Weird, but it seems the regulatory mechanism of some of these extended release drugs makes them less effective for many reasons.

Dean, I Am so sorry
 

http://www.drugs.com/interactions-ch...862-441,71-747

I ran a drug interaction for you. I hope that you find some relief. Do you take Requip? it helped me through many times.

michael

Ron, toyL and C/G
 

Dear toyL and c/g,
I used to find Sinemet CR was one of the worst offenders for dyskinesia.
Ron makes a good point about your tremor symptoms sounding more like dyskinesia.
I might be wrong since I don't have a tremor but I didn't think head tremor was part of PD tremor but more of an Essential Tremor symptom so maybe check that.

Ron, I too 1/4 just about every dose I take except I find Madopar easier to quarter.
The new Sinemet is a bugger of a thing to quarter accurately even with a pill cutter I found otherwise I would have continued on it.
Do you have the same problem?

Took requip several yrs ago. By the time I titrated up to a therapeutic dose, my ankles swelled/hurt...had to use crutches for a few days. Funny thing is that the requip was actually beginning to ease my stiffness. I long ago went thru all the agonists. No more for me. Thanks, Michael.

Called my neuro, and left info/msg/? on 7/1/12. Reply from doc was to stop taking the SA (CR). I did so that evening, and several hours later (am on 7/2/12) I was nice and calm. Got a good-nites sleep for a change. Did very well up until a couple of hours ago (330 pm 7/8/12). Dyskinesia starting to kick back up again. Not quite as bad, yet...so far, that is.
So, YOU guys were RIGHT...thanks for all your replies.