Beat of health,

Its my understanding that R XL was approved July 1, 2008.
Has anyone been started or switched to it and what were your results?

(I have posted this on the Message board as well)

The doc wanted me to wait another week before starting the baclofen. I think more so to see if I was having any adverse reactions to the Requip XL, but the cramps and twisting toes are getting to be too much. I'm going to start the baclofen tomorrow- see if it helps. If it does then I could assume the XL is working okay at this dose, but if I still have these issues then I should look to up my XL dose.... good thing the walking speeds and fluidity (not sure if it's a word or not, but I like using it) are still going good.

Oh, sorry for the long post already but I have one more question... mid-July I developed dyskinesia in my left shoulder- mostly when I drove at 5-6 pm... those have calmed down a lot now since starting the XL (when I'm fatigued they seem to pick up, but if I'm pretty rested feeling it's not happening too much anymore)- that's good, but when that shoulder started I developed this unbelievable ache in my shoulder, arm and hand (I've had this before- I think the 'frozen shoulder' thing?) but now it's on my right side too.... is this perhaps from the Requip dose- would it be considered too high (too much in my system) or too low? And lastly (whew- thanks for your patience!) my doc is still hung up on a dx- he thinks I have too much dystonia, but I do also have young onset PD symptoms too- I read that resting (I would assume the twisting toes at 3 am waking me from dead of sleep is resting?) dystonia is not a true 'dystonia' type symptom but more commonly found as secondary to 'other' underlying conditions. Do you know if my understanding of this is correct... and if so... then would it appear that these twisting cramps could all be YOPD related?

Oyvay- sorry again for the long post!!!

May I ask to bombard you with some questions? What were your first pd symptoms 5/6 years ago? You've been on Requip 5 years- how far into your pd diagnosis were you when you started the medication? How long after starting the Requip did you begin to have the fluctuations and dystonia? Was dystonia an original symptom for you before starting the Requip, or did it come on with the extended use of the Requip... or did it not start until after you added the sinemet? If it was an original symptom, has it increased and/or intensified with your Requip use?- your sinemet use? What does your doc say about that?

I'm frustrated with how great I feel on the Requip- but I've only been on it 5 months and already having all these dystonia and dyskinesia issues...doesn't it seem TOO early for these things? I read they should be later, I read they could occur with 7-24 mg daily doses on Requip- I was on 9...so yes, but after 5 months?...

Anyway. I started the baclofen last night- the pharmacy did not give me any titration instructions- said it was 10 mg 3xday. I took it last night at bed and woke feeling same as before- toes cramping, stiff and tight, same old thing that I've been having the past 2 months or so. So, I took another 10 mg dose this morning- whoofta, I'm having difficulties focusing, a swoony spacy feeling, almost a nausea feeling.... so I would guess the baclofen needs to build up in my system first. Maybe I'll hit okay levels at 20 mg day, or maybe I'll have to go to 30 or more- I read some people do hundreds of mg's a day.... so we'll just have to see how well it goes for the dystonia and dyskinesia- that's what he gave it to me for. Right now I would just like to feel better- not that I feel horrible, but I would SO like to not have these toes twisting many times a day!! email if you have any questions or thoughts you'd like to share... donalddouglas at comcast dot net.

At this writing I am at 4mg a day, and while there has been some side effects like somnolence and moderate nausea, all in all the therapy works very well.

However, just as PD is different in each person, this like all other anti-Parkinson's medications act differently in each individual. My experience is that, regardless of the particular side effects you may be experiencing, one can expect to have to endure most of them for up to a month after titration has stopped and you have reached your effective dose (which also differs from person to person).

Each time titration occurs, expect another round of side effects as well EVEN IF MOST HAVE GONE AWAY after adjusting to your previous dose. The rule of thumb is that once an acceptable therapeutic response occurs, stop all attempts at increasing the dosage.

Also, read the product/patient information to see what you might expect as side-effects. I have noted from others that some of their experiences with this drug fall outside of the side effect profile for Requip XL and may be sign of something not connected to its use. With any drug, if you experience something that doesn't sound like anything described in the patient information, make sure your doctor or pharmacist knows immediately or seek medical attention just in case it might be something else.

Make sure you hang in there. Now you know the signs to look out for, make sure you contact his dr asap if you start to see them.

You did the right thing.

Best of health,