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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by ross co on June 5, 2003, at 9:56:13
anyone try it????
Posted by Ame Sans Vie on June 5, 2003, at 10:26:08
In reply to MIRAPEX anyone?, posted by ross co on June 5, 2003, at 9:56:13
You can find my experiences with Mirapex on these threads:
http://www.dr-bob.org/babble/20030520/msgs/228132.html
http://www.dr-bob.org/babble/20030525/msgs/229574.html
Posted by jrbecker on June 5, 2003, at 10:44:09
In reply to Re: MIRAPEX anyone? » ross co, posted by Ame Sans Vie on June 5, 2003, at 10:26:08
that's great news that you report less anxiety with mirapex than wellbutrin. Hypothetically, do you think there might be a noticeable anxiety/hyperlocomotor/irritability effect, but that this is being dampened by use of the klonopin? Just curious, since I might consider an adjunct trial of it myself someday.
Posted by rod on June 5, 2003, at 14:51:23
In reply to Re: MIRAPEX anyone? » ross co, posted by Ame Sans Vie on June 5, 2003, at 10:26:08
Hi Ame Sans Vie,
I am wondering about what you said:
"By the fourth day, I remember waking up early, not needing my morning coffee--or even a cigarette."Could it possibly be, that you have Restless Leg Syndrome and now just get good sleep? (DA-agonists are also used to treat RLS, as you probably know)
I have once contacted a neurologist, via email, about how to know if one has RLS, and if the typical symptoms of the restless legs when you lie in bed is a must for being diagnosed with RLS. He answerd "no, in fact it can occur without the typical symptoms."Have you ever excluded this possibility? well, you probably dont care anymore, because its just working for you.
I am just curious, and would like to hear from you.
Roland
Posted by Ame Sans Vie on June 5, 2003, at 15:21:11
In reply to Re: MIRAPEX anyone? » Ame Sans Vie, posted by jrbecker on June 5, 2003, at 10:44:09
> that's great news that you report less anxiety with mirapex than wellbutrin. Hypothetically, do you think there might be a noticeable anxiety/hyperlocomotor/irritability effect, but that this is being dampened by use of the klonopin? Just curious, since I might consider an adjunct trial of it myself someday.
Hi,
You know, it's funny that you bring this up, as I just went through Klonopin withdrawal for the first time ever (or so I think). I've quit Klonopin cold-turkey many times before, at doses higher than I take now. But for some reason, when I ran out early (my doctor told me to take an extra 2-4mg to help cope with my new job; then he was out of town and the pharmacy couldn't call him to confirm a refill!!), I ended up having symptoms--extreme sleepiness, tingling in my hands and face, and nausea. Surprisingly, the anxiety didn't come back. And as far as I know, all three of those symptoms (I'm not sure about the tingling feeling) are possible side effects of Mirapex. So it may have been the Klonopin that actually offset the Mirapex side effects, including sleepiness! But as I said, the anxiety was still not an issue, probably because I've been taking such a high dose for so long and was only without my medication for a few days. I finally called them up and complained until they refilled it last night. :-)
Posted by Ame Sans Vie on June 5, 2003, at 15:23:17
In reply to Re: MIRAPEX anyone? RLS? » Ame Sans Vie, posted by rod on June 5, 2003, at 14:51:23
> Could it possibly be, that you have Restless Leg Syndrome and now just get good sleep? (DA-agonists are also used to treat RLS, as you probably know)
Actually, I do have RLS, and this has been treated just fine with Klonopin for quite some time now. Perhaps the Mirapex does have a synergistic effect in this area, but I tend to believe it's the activation of the dopamine reward system (i.e., lack of need for morning coffee or cigarette) that is at work here. Just my theory though. :-)
Posted by Ame Sans Vie on June 5, 2003, at 15:24:13
In reply to Re: MIRAPEX anyone?, posted by Ame Sans Vie on June 5, 2003, at 15:21:11
Posted by jrbecker on June 5, 2003, at 17:00:03
In reply to Re: MIRAPEX anyone?, posted by Ame Sans Vie on June 5, 2003, at 15:21:11
Perhaps it is partly the klonopin withdrawal, but sleepiness is sometimes reported on dopamine agonists. When I had a trial with Requip a year ago for sexual-side effect, I was profoundly sleepy/groggy for the next 12 hours -- lights out. I think it's some strange interaction with my atypical depression. I'm assuming Mirapex will produce a similar effect but am willing to give anything a try once. Can you rate or liken the sleepiness of Mirapex to something applicable?
> > that's great news that you report less anxiety with mirapex than wellbutrin. Hypothetically, do you think there might be a noticeable anxiety/hyperlocomotor/irritability effect, but that this is being dampened by use of the klonopin? Just curious, since I might consider an adjunct trial of it myself someday.
>
> Hi,
>
> You know, it's funny that you bring this up, as I just went through Klonopin withdrawal for the first time ever (or so I think). I've quit Klonopin cold-turkey many times before, at doses higher than I take now. But for some reason, when I ran out early (my doctor told me to take an extra 2-4mg to help cope with my new job; then he was out of town and the pharmacy couldn't call him to confirm a refill!!), I ended up having symptoms--extreme sleepiness, tingling in my hands and face, and nausea. Surprisingly, the anxiety didn't come back. And as far as I know, all three of those symptoms (I'm not sure about the tingling feeling) are possible side effects of Mirapex. So it may have been the Klonopin that actually offset the Mirapex side effects, including sleepiness! But as I said, the anxiety was still not an issue, probably because I've been taking such a high dose for so long and was only without my medication for a few days. I finally called them up and complained until they refilled it last night. :-)
>
>
Posted by Ame Sans Vie on June 5, 2003, at 17:29:27
In reply to Re: MIRAPEX sleepiness » Ame Sans Vie, posted by jrbecker on June 5, 2003, at 17:00:03
> Perhaps it is partly the klonopin withdrawal, but sleepiness is sometimes reported on dopamine agonists. When I had a trial with Requip a year ago for sexual-side effect, I was profoundly sleepy/groggy for the next 12 hours -- lights out. I think it's some strange interaction with my atypical depression. I'm assuming Mirapex will produce a similar effect but am willing to give anything a try once. Can you rate or liken the sleepiness of Mirapex to something applicable?
Mirapex sleepiness feels *exactly* like going a night without sleep. You just feel naturally tired, and have this irresistible urge to lie down and close your eyes.
As for sleepiness and DA agonists, there is actually a warning to those who take Mirapex that a narcolepsy-like side effect may occur. That is, you may suddenly feel very sleepy or even fall asleep while performing important activities. You may want to check out the Mirapex prescribing info at http://www.mirapex.com.
Posted by HenryO on June 6, 2003, at 0:30:50
In reply to MIRAPEX anyone?, posted by ross co on June 5, 2003, at 9:56:13
I am delighted that Mirapex works for "Ame Sans Vie". Is there anybody else posting with personal experience of this drug?
Posted by jrbecker on June 6, 2003, at 11:28:59
In reply to Re: MIRAPEX anyone? RLS? » rod, posted by Ame Sans Vie on June 5, 2003, at 15:23:17
Very recent research on RLS...
http://www.sciencedaily.com/releases/2003/06/030606080610.htm
6/06/2003
Study Suggests Cause For Restless Leg Syndrome; Underdiagnosed Syndrome May Affect 5 Percent To 10 Percent Of U.S. Population
Restless legs syndrome (RLS) may sound like something right out of a 1950s horror flick. And for some sufferers, it is. This affliction causes an irresistible urge to move the legs often accompanied by creepy-crawly sensations in the legs. The sensations are only relieved by movement, and become worse as the sun goes down. Night after night this sleeplessness occurs for the millions who suffer with RLS and their partners.
Because little is known about what causes RLS, researchers at Penn State College of Medicine and Johns Hopkins University went looking for answers. The team, led by James Connor, Ph.D., professor and interim chair, Department of Neuroscience and Anatomy, Penn State College of Medicine, performed the first-ever autopsy analysis of the brains of people with RLS. This research, presented today (June 5, 2003) at the Association of Professional Sleep Societies meeting in Chicago, uncovered a possible explanation for this syndrome.
“We found that, although there are no unique pathological changes in the brains of patients with RLS, it appears that cells in a portion of the mid-brain aren’t getting enough iron,” Connor said. “It was a relief to many that there was no neurodegeneration, or loss or damage of brain cells, like we see in Parkinson’s and Alzheimer’s disease.”
The discovery of a physical cause for this disorder establishes it as a sensory motor rather than a psychological disorder. Because cells aren’t lost or damaged but rather iron-deficient, there is more hope that treatments can be developed.
For the study, Connor examined brain tissue acquired through the Restless Legs Syndrome Foundation’s brain collection at the Harvard Brain Bank. Tissue from seven people with RLS was examined and five samples from people with no neurological conditions served as controls. Cross-sectional slides of the substantia nigra, the portion of the middle brain thought to play a role in RLS, allowed the research team to thoroughly examine the cells’ structures and functions. To avoid bias, during examination, the investigator did not know whether the sample was that of a patient with or without RLS.
Although it’s been long-suspected that iron deficiency had something to do with RLS, Connor’s study found that a specific receptor for iron transport is lacking in patients with RLS. When that mechanism malfunctions, enough iron gets into the brain cells to keep them alive, but not enough so that they function optimally. That missing iron may cause a misfiring of neural signals to the legs creating the creepy-crawly feelings.
“This doesn’t necessarily mean that a person has dietary iron-deficiency and needs supplements,” Connor said. “It means only that these receptors aren’t packaging and delivering an adequate amount of iron to the specific cells in this portion of the brain.”
This explains why some patients find temporary relief from iron supplements, but it is important that any supplementation therapy be managed by a physician.
Although not FDA-approved for the treatment of RLS, a few prescription drugs, which have been approved for other conditions, have temporarily relieved symptoms in some patients. One such drug is that used in Parkinson’s disease to calm tremors. The cells in the brain in RLS that are iron deficient are the cells that make the neurotransmitter dopamine. Dopamine synthesis requires iron and this is the likely reason that small amounts of the drugs that are used to treat Parkinson’s patients can be effective in RLS.
Connor’s next step is to continue to pinpoint other potential breakdowns in the iron packaging and transport system to this part of the brain, including the genes that regulate the iron transport proteins.
“We hope these discoveries lead to a test that could diagnose this syndrome, and a potential target for a therapy to bring long-term relief to those suffering with restless legs syndrome,” Connor said.
This study was funded in part by grants from the National Institutes of Health and the Restless Legs Syndrome Foundation.
Other members of the research team were: P.J. Boyer, M.D., Ph.D., Departments of Neuroscience and Anatomy, and Pathology, S. L. Menzies, Department of Neuroscience and Anatomy, and B. Dellinger, Department of Pathology, Penn State College of Medicine, Penn State Milton S. Hershey Medical Center; R.P. Allen, Ph.D., Department of Neurology, Johns Hopkins Bayview Medical Center; W.G. Ondo, M.D., Department of Neurology, Baylor College of Medicine, Houston; C.J. Earley, M.D., Ph.D., Department of Neurology, Johns Hopkins Bayview Medical Center.
> > Could it possibly be, that you have Restless Leg Syndrome and now just get good sleep? (DA-agonists are also used to treat RLS, as you probably know)
>
> Actually, I do have RLS, and this has been treated just fine with Klonopin for quite some time now. Perhaps the Mirapex does have a synergistic effect in this area, but I tend to believe it's the activation of the dopamine reward system (i.e., lack of need for morning coffee or cigarette) that is at work here. Just my theory though. :-)
>
>
Posted by jerrympls on June 7, 2003, at 3:44:47
In reply to Re: MIRAPEX anyone?, posted by HenryO on June 6, 2003, at 0:30:50
> I am delighted that Mirapex works for "Ame Sans Vie". Is there anybody else posting with personal experience of this drug?
See my recent post:
http://www.dr-bob.org/babble/20030604/msgs/232107.html
Jerry
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