parkinsons/senimet

[janpark]

I was diagnosed with Parkinsons via treatment with Senimet which stopped the shaking of my jaw. Since have been referred to another doc who said he wouldn't have started me on senimet but I was already on it. He is giving me Senimet CR as it isn't as readily absorbed, augmented with Requip. I have talked with a neurobiologist, and another neurologist who both said they would not perscribe Senimet. One said he only perscribed senimet for older patients as the dyskenisia is more prevelent with this medication. I'm 65 and still working; as well, am a church organist and need to continue as long as possible.
My question: is it possible to back off taking senimet and replace with another medicine, and is that in fact advisable? Please inform asap as my future is in the balance. Many Thanks

[Anant10]

Hi,

The treament started for Parkinson's disease (PD) depends on the disease stage.

In Early PD, if cognition is intact selegiline is started and if there is functional disability, carbidopa/levodopa (Senimet) is used.

In advanced disease, carbidopa/levodopa or dopamine agonist (Requip) as single agent is started  initially and subsequently the dose and/or frequency is increased. Other agents (selegiline, tolcapone, or amantadine) can be added as adjuncts.

In your case, shifting from Senimet to Senimet CR is the right approach. As your symptoms were controlled on Sinemet alone, addition of Requip was not required.

It's true that the dyskinesia increases when Sinemet is used in combination with Requip.

At this stage, replacinf Senimet with Requip is not advisable and you should continue taking Sinemet CR

[janpark]

Thanks! Are you speaking from a professional medical position or has this been your experience? j.

[janpark]

What is your experience, all be it limited in that this is a new med, but he changed me to azilect. I haven't even started it yet, but the thinking is to see the reaction, then back off Senimet. Any thoughts? I'm grateful for the reply. j.