My husband takes a 5mg. tablet of Zypexa each night.
I am sure a lot depends upon how much Sinemet/agonists the PWP takes and how long the PWP has had PD. When he began hallucinating, several years ago he was on a large about of Sinemet - approx. 20 - 24 reg. Sinemet tablets per day (no agonists).
Now, as of today he takes 9 Sinemet a day, yesterday he was on 7 Sinemet a day (all of which are 25/100, some regular, some CR. He does take Requip (4 a day) too. Every patient is different. But, decreasing the Sinemet appears to be the first step in stoping hallucinations and adding an antipsychotic.
I recently read in the Summer, 2000, APDA newsletter an explanation of dopamine receptors:
- "D2 dopamine receptors are more prevalent in the basal ganglia where stimulation produces a strong physical benefit although with more of a chance of dyskinesia. Permax is the most potent D2 stimulator but it is derived from ergot alkaloids and may cause vasoconstriction and may cause symptoms of ergotism and dyskinesia but it has a smaller chance of inducing hallucinations and a stronger physical response."
- "D3 dopamine receptors are more prevalent in the limbic system where stimulation elevates mood and motivation although with more of a tendency to cause vivid dreams and hallucination. Mirapex is the most potent D3 stimulator - it has the least tendency to produce dyskinesia but if you give it to someone prone to hallucinate they will hallucinate."
- "Requip is more in the middle, closer in action to Mirapex and Permax but with less of the side effects of either."
So, if you're prone to hallucinate you should stay away from Mirapex; and if you're prone to dyskinesia stay away from Permax.
