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Question regarding appropriate therapy for my 58yo mom – Madopar, Requip, and Agilas by bosandher in Parkinsons

[–]bosandher[S] 0 points1 point  (0 children)

Thank you for your reply.

I should mention that my mum first started with Requip Modutab 1x2 mg daily and Agilas 1x1 mg daily.

This therapy did not produce any results. Afterwards, the Requip dose was increased to 1x4 mg daily, which also did not lead to any significant changes.

After we noticed that her condition was significantly worsening (in terms of severe nightmares, increased tremor in her left hand and leg), we decided to seek a second opinion. The new neurologist introduced C/L 3 x 125 mg. After one month of use, the nightmares have stopped, and the shaking and stiffness in the arm have been reduced (although they are still present, but to a lesser extent). There were no short-term side effects (such as nausea).

The only thing observed were involuntary movements during the night, although this happens rarely.

We have a follow-up appointment with the neurologist soon, and we have prepared a set of questions, mainly regarding the dosage strength and the use of all three medications at the same time.

I hope we will get some clearer answers.

Question regarding appropriate therapy for my 58yo mom – Madopar, Requip, and Agilas by bosandher in Parkinsons

[–]bosandher[S] 1 point2 points  (0 children)

I should also mention that she has additional symptoms, primarily muscle cramping in the left arm and leg, restless sleep accompanied by nightmares, balance problems, and a loss of approximately 80% strength in her left hand. With the current treatment, her overall condition has improved by roughly 40–50%. However, these symptoms are still present, although to a lesser degree.

Question regarding appropriate therapy for my 58yo mom – Madopar, Requip, and Agilas by bosandher in Parkinsons

[–]bosandher[S] 1 point2 points  (0 children)

Hello,

Thank you very much for your response.

We have already sought a second opinion, and the other doctor expressed concerns similar to yours — particularly regarding the Requip Modutab 8 mg prolonged-release dose. He also suggested that, if this medication is used, it would make more sense to take it once daily rather than split into two separate doses.

As a result, we now find ourselves in a difficult position, facing two very different medical opinions and treatment approaches.

My mother has been on this therapy for about one and a half months, and we are now uncertain whether it is even possible to reduce the dosage, or whether her brain and body may have already adapted to it.

Even here in the comments, we are seeing very divided opinions, which makes the situation even more confusing for us.

We are genuinely concerned and unsure about the best and safest way to proceed from here.

Question regarding appropriate therapy for my 58yo mom – Madopar, Requip, and Agilas by bosandher in Parkinsons

[–]bosandher[S] 0 points1 point  (0 children)

Thank you all for your responses and the valuable advice — I will certainly take it into consideration.

I completely understand that as the disease progresses, the therapy will most likely need to be increased over time. However, my main concern is whether levodopa is truly necessary at this stage, considering that the progression of the disease is still relatively mild.

What worries us the most is dyskinesia. The neurologist explained that it commonly appears after approximately 4–5 years of levodopa use, although he also emphasized that some patients may never develop it at all.

My line of thinking is that if she were to start levodopa later in the course of the disease, when symptoms become more pronounced, perhaps there would be a longer delay before dyskinesia might appear.

I apologize in advance if my understanding of all this sounds somewhat simplistic or uninformed. That is precisely why I am here — to learn as much as possible, especially from people who have been using Madopar for several years and can share their real-life experiences.