Blogging with Parkinson's

A personal perspective on Young Onset Parkinson's

Ropinirole Diary, Titration and a New Consultant

8 Comments

Drawing of a burette

I’ve given the weekly ropinirole diary a bit of a rest of late, not least because it was getting very tedious. I think there may have been some benefit at 4mg, but it hadn’t sorted out the dystonia in my left foot (a desirable target) nor given me confidence in my ability to tie shoelaces (a measure of sorts). I was also failing the automatic watch test. It hasn’t noticeably changed my personality yet, so that much is good.

As I had a regular consultant’s appointment a couple of days ago, I decided to bring the subject up there. I was slightly surprised to find myself meeting a new consultant – apparently the previous incumbent had decided to spend less time in my local hospital (I understand that he’s based 40 or so miles away), and so I have a new consultant. Naturally, the appointment turned into a sort of introductory session where she went over some old ground, as was only right and proper.

She wanted to know why I had chosen to try ropinirole rather than levadopa; was it that I was concerned about scares that levadopa made the Parkinson’s worse? I wasn’t aware of any such scare. My reasons were more to do with the apparent limited timescale that levadopa works without side effects. She didn’t seem completely convinced, but, equally, she didn’t offer any counter arguments.

We moved onto the dosage of my ropinirole. How many tablets was I taking daily? One – the prolonged release version, containing 4mg. She evidently would have preferred it if I was on the multi-tablet regime, but accepted my argument that I’m not very good at remembering to take them. She even admitted that the one tablet she takes is quite often forgotten. The reason it is “better” to be on the multiple tablet regime is that it is easier to “titrate” the dosage – basically, the simpler tablets are available in smaller increments.  (Titration is a means of adding small amounts of something to determine the minimum quantity required to achieve a desired effect. It is done in chemistry using a burette – a long, calibrated glass tube with a tap at the bottom). But if I forget tablets at random, the titration will not work. So we’re going up 2 mg.

My agreeable GP has already supplied me with a prescription. I’ll start tomorrow… and the new consultant says that the results should be observable within a few days, possibly a week.

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8 thoughts on “Ropinirole Diary, Titration and a New Consultant

  1. I am so interested in how this goes for you! Fingers crossed!

  2. P.S. Did you continue the Azilect? I read the poor study results on the Michael J. Fox site but part of the issue seemed to be the study methodology, it still may have neuroprotective ability. I take Azilect and it doesn’t do much for me, but maybe it does enough for me to cope for a year, as it did for you. I remain soooo sleepy, i worry about taking ropinirole with the sleep concerns. I am a psychiatric social worker in private practice so I see clients in the morning, go home and nap then some days return for the evening clients. it is hard on sleepy days but still fun–tho not as fun as 2 little kids would be.

    • I’m continuing with the Azilect (rasagiline). I figure that a) it might be neuroprotective, and b) it did have some effect by itself, so it’s probably still contributing to the overall effect. And, of course, the risk of side effects is very low.

      As for the ropinirole, I don’t seem to be experiencing much drowsiness associated with it at present.

  3. That’s great!
    jeanie

  4. P.S. Have you heard that the cholesterol lowering drug simvastatin may providel neuroprotection in Parkinson’s disease. “A little known fact among the public is that statin drugs do more than simply lower cholesterol, they are also anti-inflammatory agents. In fact, many researchers believe that some of the cardiovascular benefits are due to their anti-inflammatory properties (Quist-Paulsen 2010). Simvastatin is efficient at crossing the blood-brain barrier, and it has been shown to exert potent anti-inflammatory and neuroprotective action in the dopaminergic tract (Roy 2011; Yan 2011). ” from http://www.lef.org/protocols/neurological/parkinsons_disease_01.htm?source=search&key=parkinsons

  5. Any update on the Ropinirole effectiveness?

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