mirapex and psychosis

[twhit71ca]

Hi, my husband has Parkinsons, was diagnosed at age 38, he's now 45. Over the past year he has has a few episodes of acute psychosis... he becomes paranoid where he hears voices that no one else hears and he believes they are threatening him. He is on Mirapex 1 mg three x/day and Levadopa 100/25, 2 pills 5 times / day
For the psychosis he is being treated with Seroquel 50 mg. in morning and 100 mg at night. he recently has increased Seroquel because of worsening of the symptoms.
I am wondering if anyone has experienced this, and if you were taking Mirapex, and what did u do about it??
I am desperate for any info. I am a Registered Nurse and eager to help my husband.

[Nan Cyclist]

After a multitude of difficulties, some of which you describe, I got off of Mirapex and have had few episodes such as you mentioned since. The threatening people always approached me in my dreams and I became very violent trying to fend them off. I was diagnosed with REM sleep behavior disorder and now take a half milligram of clonazepam at night with great success. Each story is different however so my story may not be his story.

[Dianna_Wood]

Anotherwords, PD is lack of Dopamine. Schezophrenia is too much dopamine. If your husband was doing well on Sinemet (YOPD are more sensitive to Sinemet) why did the neurologist add Mirapex to the med list? This will make more dopamine available to the brain and if your husband is as sensitive to Sinemet as I am, He may be getting more Sinemet than he needs.

Doctors follow what is written in research. If research says to add a MAO inhibiter then thats what they do. Most neurologists start a patient newly diagnosed with Eldepryl, and wait as long as it works before adding Sinemet.
Sinemet has bad side affects after 20 years. At your husband's age time goes by fast. Maybe you might want to get a second opion if your current one is not open to discussing options such as taking him off Sinemet or putting him on Requip (another drug simliar to Mirapex but fewer people seem to suffer side effects.)

Keep in touch and let us know how both of you are doing.

Dianna

[Conductor71]

Mirapex is a dopamine agonist and research substantiates that agonists can and do commonly cause hallucinations. This is the main reason why elderly people with PD are not prescribed agonists.

Your hub is over medicated. Most neuros want us young pwp to be on as high a of dose agonist and low a dose of Sinemet as possible. The meds are all self trial and error.

Given that the agonist is more likely the culprit based on research and patient confirmation, I would target the Mirapex first. Is there a reason why your doctor is band aiding the psychosis rather than ridding of it by slowly lowering dopa drugs? Is that mix optimal for his motor symptoms? We develop tolerance to both drugs and they do set off addictive type behaviors in some patients. The agonists in particular can cause withdrawal symptoms. It is very important that meds are not stopped abruptly. As a nurse you may know this, but doing that can cause a life threatening condition called Neuroleptic Malignant Syndrome.

In my experience one can be totally over medicated and not know it due to tolerance. I went from 12 mg of Requip to 8 mg in two months; actually felt better, and my PD symptoms were no worse. I also take Sinemet. I have had the same med combo as your hub and at half his levodopa dose and I was bouncing off the walls, so I cannot imagine what you are both going through right now.

If your hub really needs the agonist too then you could always ask doctor for an extended release version because there would be a more regulated receptor stimulation and then likely no voices.

Please update us!

Laura

[Drevy]

Originally Posted by twhit71ca

Hi, my husband has Parkinsons, was diagnosed at age 38, he's now 45. Over the past year he has has a few episodes of acute psychosis... he becomes paranoid where he hears voices that no one else hears and he believes they are threatening him. He is on Mirapex 1 mg three x/day and Levadopa 100/25, 2 pills 5 times / day
For the psychosis he is being treated with Seroquel 50 mg. in morning and 100 mg at night. he recently has increased Seroquel because of worsening of the symptoms.
I am wondering if anyone has experienced this, and if you were taking Mirapex, and what did u do about it??
I am desperate for any info. I am a Registered Nurse and eager to help my husband.

Welcome!

Your husband's case is VERY similar to my husband's. He too was diagnosed at 38 and is turning 45 today

Let's see, about two years ago his doctor prescribed Mirapex. He was on it for about two weeks and he just couldn't hack it. It literally knocked him down...he became extremely weak and not functional at all. He could not even get up from sitting or laying down without someone else's help and I even had to bathe him because he couldn't do that either. He was miserable and it was heart-breaking to see him that way!!! It was incredible...he went from being very self-reliant to non-functional in just a matter of days from starting Mirapex. I called his neurologist a few times because obviously I was very concerned and he kept saying that we had to give it time but after seeing how my husband kept deteriorating on a daily basis I pretty much just "told" the doctor (didnt ask at that point) that he was stopping it, and he did. He bounced back in a little over a week and until now no other med has hit him so hard.

My suggestion to you would be to look at what other options your husband has instead of Mirapex.

I am not a doctor but based on my husband's experience, what I've heard from others, and what Mirapex is, I definitely don't want it any where near my husband!!! He's on Requip XL and Sinemet. He recently stopped taking Azilect as well and that is also going well! Like someone else said before, this for the most part is about trial and error. Don't be afraid of "challenging" the doctor(s)... the fact that you're a nurse is a big plus.

I sure hope this helps!

Wishing you and your husband all the best...

Silvia