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Topic Replace Mirapex with Requip? Go to previous topic Go to next topic Go to higher level

By mytngenes On 2009.11.04 22:22
I am new here. Just found out about this forum last night. I am so thankful to know that yall are here and are going through some of the same things I am!!

My husband is 55 yrs old, dx'd in 1998. He has been on Mirapex since the get-go. For the past several years he has been experiencing obsessive/compulsions and behaviors that are becoming out of control. The buying/spending/draining our bank accounts and internet shopping/pornography/chat has become so extreme, and he is now seeking extreme ways to get what he wants. I'm having to take drastic measures to make sure he has absolutely no computer/banking access.

My question is about the Mirapex. I understand that it can be the culprit for these behaviors. And I've also read that Requip is another dopamine antagonist used by Parkinson's patients. BUT, will I just be swapping meds but getting the same results? I don't think there is any way he can go off of Mirapex without replacing it with something similar to help the Parkinson's symptoms that he exhibits(stiffness/pain/slow gait, fatigue, depression).

He also takes a very high dosage of Sinemet CR-7.5 pills a day, with a Comtan each time he takes Sinemet. Could this also be adding to his behavior problems?

I work full-time, 45 minutes away from home, so I'm not here to montior his every behavior. He's driving me insane with the spending and lying about it and the pouting/hypersexuality. Is there any recourse?

Thanks for listening

By annwood On 2009.11.05 00:04
Welcome to our forum! I hope that you will find some support here from many of us who have or have had loved ones with PD. It sounds as if you have some of the problems many of us have dealt with. I don't know that we have all of the answers but it helps to know that there are others in the same boat.

My first thought in reading your post is - Have you discussed this behavior with your husband's physician? Is your husband seeing a neurologist or preferrably a movement disorder specialist? PD is very complicated and it needs to be treated by someone who specializes in the disease.

All of the dopamine antagonists seem to cause compulsive behavior in some people. These compulsions include all of the behaviors you have outlined. Not much to do about it except stop the medication. It is a trade off between the behavior and the possible increase in symptoms if he doesn't take them - only the physician can advise you. I would also question the use of Comtan - it is my understanding that this drug is not used much anymore. Again ask the physician.

Sounds as if you are taking the appropriate actions - controls on the computer, stop the credit cards and change the bank accounts. We call that "tough love" here. Read the posts of Bandino1 for more info on this. Your husband will do everything in his power to convince you to allow him to do these things and he will be angry when he doesn't get his way - too bad. There have been some real nightmare stories involving this topic so you must be firm and take charge.

It is difficult to answer all of your questions at once so stay with us and we will do all we can to help. I would also suggest that you search previous posts here for Mirapex, Hypersexuality, Compulsive Behavior.

By Emma On 2009.11.05 05:31
Welcome, I'm glad that you found us and hope that we will be a help to you.

Definitely discuss this with your husbands doctor. My husband takes Requip and has for eight years. He has the same kinds of problems as your husband, but not quite to the degree that you describe. I think the medications are different for everyone, you really need to talk to the doctor. Our neurologist just reduced the Requip to one small dose at bedtime for restless legs. He reduced it because I called him in a state of near nervous breakdown from the sexual obsessions. It seems to be helping and I haven't noticed any deterioration in his physical symptoms. If you don't already have one, get a Power of Attorney, it will help with being able to control the money.

Good luck and stay with us.

By Reflection On 2009.11.05 09:54
My understanding is that mirapex and requip operate in the same way, so have the same issues.

Dosage is also an issue - my husband has had horrible problems of the type you describe, and over time convinced his neuro to prescribe absurdly high doses (60 mg a day - over twice maxium recommended amount. )

You might want to read, and perhaps print out, this recent study from the Mayo Clinic, that says that roughly 20%, and perhaps more, of those on more that 6 mg of requip or more developed compulsive behaviors. The guy on the highest dose, 24 mg/day, developed "Pathologic gambling, pathologic hypersexuality, increased food and alcohol consumption,compulsive hobby work"

Frequency of New-Onset Pathologic Compulsive Gambling or Hypersexuality After Drug Treatment of Idiopathic Parkinson Disease

http://www.mayoclinicproceedings.com/content/84/4/310.abstract?ijkey=f9f806f40b7ebec7c1063d6b9868d9ac463db19b&keytype2=tf_ipsecsha

Good luck - and be firm with the neurologist.

By packerman On 2009.11.05 12:10
welcome to the best place to get the answers you're looking for!

my experience with the issues you're dealing with have been more from the bipolar perspective and response to meds than the PD side, but i've been there too.

hang in there!
hugs,
Pat

By dkleinert On 2009.11.05 22:43
Welcome to this wonderful group of Caregivers and those with PD. You will find help, encouragement and courage here. My husband took Requip for 3 years at the beginning after his diagnosis, but began having auditory and visual hallucinations constantly, and we had to stop it. He was on a pretty high dose, however. Now he takes Mirapex and Sinemet in large doses. So far, the behaviors are compulsive game playing on the internet, listening to books on tape constantly from beginning to end - won't even stop to eat or sleep sometimes.....I had to take away all access to money and any way for him to spend money - he nearly put himself in jail for all of the hot checks he wrote and nearly bankrupted us from the overlimit charges on credit cards (we don't use them anymore), bank charges, etc., and made me afraid to go anywhere I wanted to write a check or use a debit or credit card. I never knew when someone would decline my purchase because he had written bad checks and I had not found out yet.....it was awful.

Now that he cannot do that any longer, that part if OK, and so far there has never been the pornography obsession (at least I don't know about it) - he seems more asexual now. Does not even seem to care about it at all anymore.

Speaking candidly with his Neuro or your Family doc hopefully will put them on to the need to correct his medications. What you are going thru in addition to the other PD issues is so hard - especially that you work full time and are away from home so much - you must really worry.

Keep in touch with us - you can bring up ANY subject here and always feel free to say what you need to say. Hugs to you.

By mytngenes On 2009.11.08 13:42
Update: I was able to get my husband to agree to removing his name from the checking/savings accounts at the bank. We went last Thurs and did that...no problem as he was very agreeable. We also discussed making the change from Mirapex to Requip. We had talked to his MD Specialist about this last year, but since the meds were controlling his motor problems so well, the dr did not want to change anything (sound familiar?). We also agreed that we MUST give it a try. Not only is there the chance that he can better tolerate Requip w/o the compulsions/obssessions, but Medicare will cover Requip and it won't Mirapex. I left town Thurs afternoon to move my parents in to an assisted living facility (thankfully, that went very well!) and James called an left a message for the dr. He did not hear back on Fri, so I'm calling tomorrow about that. Also, he brought up on his own that he feels he does not need to be driving. Wow! This was a complicated issue but due to the fact that he would take the car and be gone for hrs at a time, I was ready to confront him on it. Thankfully he mentioned it first. Our 2 sons and 1 daughter-in-law are here with us, until they are able to find jobs (college grads, now in grad school), so they are able to drive James wherever he needs to go.

Thanks for all of your ideas/suggestions/encouragement!!

~Sherri

By rmshea On 2010.11.27 11:50
A member of our family was on Mirapex for restless leg for several years. She developed hoarding compulsions and stealing. She was arrested this past spring for shoplifting. The psychiatrist took her off Mirapex immediately and the compulsion to steal has stopped. However, she is addicted to Lortabs, has been for 15 yrs and it's hard to tell what is doing what to her brain. My son is on Adderall, although he doesn't take it like he should/could; it's hard to tell if the benefit is worth the risk. Some days it is, some days not so much. These drugs are nothing to fool around with for anyone; benefit/risk has to be a huge consideration and the docs only know what the pharm salesmen tell them.

By cgold On 2010.11.27 16:28
Welcome to the forum. I would discuss with your Neurologist the pros/cons of changing meds. My husband tried Mirapex, but was unable to tolerate well. He was changed over to Requip. It is my understanding that both meds can produce the same type of behaviors. Not everyone experiences the same issues as a result of the meds. And, the meds can also react in each person in a different manner. You really need to weigh relief of the disease and dealing with the behaviors. I would recommend that you discuss the possibility of tweaking the dose and timing of the meds. This may help reduce or for that matter eliminate the behavior. I would also consider changing to a Neuroligist Movement Specialist.

By lurkingforacure On 2010.11.27 19:13
We tried to switch from mirapex to requip with disastrous results. Here's what happened to us:

1. neuro told us to just swap out the drugs, no titration schedule. he's at one of the supposed best PD centers in the world so I figured, he knew. This probably works for most PWP, but did not for us.

2. we upped our requip as he told us to and it never took any effect. My husband said it felt like he took nothing at all. requip did cut down on the sleepiness he got from mirapex, but this was because he wasn't taking mirapex! requip did nothing for our symptoms and we were taking 16mg a day by the time we gave up.

This was a really bad experiment for us. I've also learned from a friend on another forum that after taking requip for ten years and maxing out on 24mg a day for several years, he learned requip was actually causing his dyskinesias. He got completely off requip in a couple of days, upped the sinemet, and the dyskinesias are gone. Go figure. Who knows if this would work for others, but it was pretty interesting to me.

BTW, we found out later that the neuro who tried to switch us from mirapex to requip gets about 10K a month from the maker of requip to speak in favor of it at neuro seminars, lectures, etc.

By packerman On 2010.11.29 10:48
my hubby has been on Requip for over 10 years with no bad side effects.
everyone is different...


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