Do people with tremor dominant PD respond to different meds than people with stiffne
 

I am just wondering if people with different dominating symptoms respond differently to meds. I don't have a tremor (unless I'm really nervous) but suffer from stiffness and bradykinesia. Am wondering what meds people with these symptoms are on that are particularly helpful. Apart from L-dopa which seems to help most people.

Trixiedee

My husband is two years into his diagnosis, and has bad tremors in both arms. He is on Requip XL 18mg twice daily, and Madopar 100/25 three times daily.

Unfortunately, the medication doesn't stop the arm tremors, although they would probably be far worse without it.

Fortunately he doesn't experience any stiffness.

Hope this is of interest to you.

Tremor hard to treat
 

I have all tremor types (lucky me)...:p

Started with action, postural, and now resting. Prior to PD diagnosis, I responded to a beta-blocker. Now l-dopa helps me so much that tremor rarely emerges anymore. I also still respond to a beta-blocker.

From what I have heard, tremor is not always responsive to ldopa. I have heard it can be hard to treat, so I feel fortunate.

Laura

You are indeed fortunate Laura to have your tremors under control - my husband would give anything to have the same.

Perhaps he ought to talk to the neurologist about beta-blockers when we next go?

Last October I bought an exercise bike, but since using it for ten minutes daily, his arm tremors are considerablly worse, and I'm wondering if the cycling could have caused this.

Any advice would be gratefully received.

Trixiedee and Budgies ...
 

his tremors could be worse simply due to physical exertion tiring the muscles and leaving him out of breath. It is tough to know as we don't know his age or state of health or general fitness level.

I do know that exercise is claimed to be only good for Parkinson's and I feel my exercise program has helped.

I would stick at the cycling and as he gets fitter the tremors may become less, (assuming he was relatively unfit, which may be a wrong assumption).

Trixiedee, as for the original query, I remember a thread about a year ago which defined a number of Parky profiles and there response characteristics. See the link below, it may be of some help.

http://neurotalk.psychcentral.com/thread101685.html

Neil.

I am tremor dominant; l-dopa is effective - but Amantadine helps.

I am definitely tremor dominant (big bad noticeable tremor, both sides now) and have not yet found the right med to control it, or the right combo of meds. I've tried a few, had some fairly minor benefits but nothing that worked for tremor, and nothing worth the side effects. I'm on a very low dose of Sinemet (higher doses gave me dystonia--muscle cramping--right away). Also tried Amantadine, again some benefits, not for tremor, and intolerable side effect--severe insomnia. Brief Mirapex trial, did nothing for me, but got vision problems after just a few weeks (MDS said unrelated, but seemed like a big coincidence to me). If anyone finds the right stuff, I'd love to know what worked for you, esp. in cases where Sinemet didn't (like maybe the ET meds, for example?).

Thanks for that Neil.

At the moment he is "resting" from the exercise bike to see if his tremors lessen. It's only been three days since he last used it, and so far the tremors haven't subsided at all.

I just hate the thought that the tremors are getting progressively worse.

We walk at least 2 miles daily, and for 68 he is pretty fit, so I'm keen for him to keep up the cycling. As you rightly say, I have only read good can come from exercise.

Unfortunately, for the cycling to work, the patient needs to go for at least 40 minutes at 60-80 rpm three times per week. Add 10 min of warmup and cooldown. Keep the heart rate at 60-80 of maximum heart rate (220-age). Most people have to build up to that, but it is possible. In addition to cycling and meds (6mg ReQuip XL/day) another PD patient taught me to use a form of self-hypnosis to control the tremor. I was dubious, but found that by being still and saying "Quiet hand" on breathing in and "Peace" on breathing out my tremor usually stops, especially when I'm trying to go to sleep and I keep patting myself!

Thanks for that Nan, but surely even ten minutes of cycling daily to the best of his ability has got to be a good thing?

I don't know if we're imagining it, but since giving up the bike four days ago, his arm tremors seem to have improved slightly. Having said that, from all that I've read, I do think it's important that he goes back to the cycling and tries to reach the goal you've described, albeit possibly in the distant future.