I may seem scornful of medication in these posts, but actually I am very grateful. Perhaps with a stronger will I could override the need for them, but for now, they're a blessing. After I was diagnosed, I went as long as I could without them, and now I am dependent.
I know that now because I tried to eliminate one - pramipexole, the generic for Mirapex. It was the first medication prescribed for me and it worked miracles, but it didn't last. Its efficacy lasted a year before carbidopa levodopa had to be added to keep me at the same level of functionality. So now after 7 years of pramipexole, I wondered, what could its efficacy be, was it still enhancing the CL as Dr. V said it would, or was it just a chemical drifting unnecessarily through my bloodstream?
My new neurologist, Dr. F went along with that when I suggested I was overmedicated. I said I would like to reduce my meds because I didn't like the diskinesia I was experiencing as a side effect. Though she said that the CL was usually the cause of the dyskinesia, she said I could try eliminating one pramipexole to see what happened, and if that seemed to make no difference, to eliminate another. As I recall that was the entire conversation about eliminating paramexipole.
I was on a 3 per day dosage of the drug. Over about a week and a half (but I wasn't keeping records so I'm not sure) I eliminated one pill at a time. I had to adjust a little, but after a few days with the elimination of one paramexipole I thought I was doing well enough to eliminate another. And then I had none.
Before too long, things went downhill. My "off" periods became more frequent, longer and more intense. I felt my body contract and shut down. I thought I would adjust, but it got worse.
On an evening walk with my husband on the second day without paramexipole, my mood became gloomy. I talked about all the things that were negative about my family, all my worries, fears and from there moved on to other dark subjects: the woman that was killed at the intersection on Nassau Street for instance. We sat on a bench in a pretty spot on the University campus and I leaned my head on my husband's shoulder. While gazing at the moon, tears came to my eyes and rolled down my cheeks. What was strange to me was that I could not get out of this depressed mood. This was uncharacteristic of of me - I am usually a positive person.
Back at home I tried working in the studio, and though I was dressed lightly on this cool October night, I began to sweat profusely, sweat dripping off my nose. I am past menopause, hot flashes no longer plague me, so what was going on? A little light glimmered in my mind. Could it be withdrawal?
Ahhh, at last I understood. When I went to the internet and searched I found that withdrawal from pramipexole, if done too quickly, induces a withdrawal comparable to that of cocaine withdrawal: depression, anxiety, sweating, headache, nausea. I went to take a pill hoping it would give me some quick relief, but over the next 24 hours I was to experience the other symptoms as well. Very tired, I slept on and off in the reclining chair all the next day, just waiting to feel better.
I spent the following days experimenting with dosages, dividing pills of the paramexipole in halves and in quarters, trying to find the best course with that drug and also with the carbidopa levodopa. I kept a log and now have worked out what I think is the best schedule of medications for me. I take a total of 2 pramipexole a day and CL every three hours until dinner, then I don't take more unless I am going out or have plans that night.
The meds work for me. They work so I can work. After finding the right drug regimen, I was able to spend an entire day with no "off" periods selling my pottery at a craft fair. The only problem now is that I had a fall and injured my ribs (broken, fractured, bruised, I don't know) and that is holding me back. Ribs take a while to heal. Falls are another Parkinson's weakness.
Drugs drugs drugs. Who knew I
would take to them so thoroughly that I'm writing all about them in this blog. They help me live the life I want, and for that I am most grateful,
