Apomorphine


#1
Hi all,

It's your favorite story teller here. (and yes part 3 is on the way). I was wondering about Apomorphine and wether it's worth gi8ving it a try, as I've tried every other medication there is on the market. I'm due to go to Bristol Hospital in July to discuss the next stage of treatment, DBS.

I asked my neurologist what other options there were available if it was decided that DBS would not work, as it doesn't work with everyone. He mentioned Apomorphine. Why he didn't recommend I try that first before DBS I'll never know.

Having done aq little research on it, it appears it was first moted as a treatment for PD as early as 1951 but it's first clinical use was in 1970. So how come I've only just heard about it? Is it a secret? Or just not widely advertised. I wondered if anyone else had used this treatment and how they got on with it.

Regards
Mick

#2
Hello PoppaS, I have been using apo morphine pens for about 6 months now and they have been good. I use it in addition to my usual PD meds as and when I require it, which at the moment is 3 times daily, injecting myself took a bit of getting used to but the results are worth it.

It must be noted that it is a DA and on this basis I was concerned about using it as I developed an OCD when I used DA'a 8 years ago and it financially and emotionally destroyed us. This time however we hoped that our previous experiences would help us to recognize any changes in character or unusual activities quickly. Due to my adverse reaction to previous DA use I was considered an unsuitable candidate for the apo morphine pump but as the injections only last for about an hour and a half it was considered the best option for me. So far so good and I have found the pens to be very beneficial.

The injection kicks in within about 10 minutes and it stops my shakes almost completely and although it doesn't appear to completely get rid of any pain it certainly helps me feel better.

I do hope that you give them a try and please keep us updated?

glenchass

#3
Hello Papasmurf.

I did write this post before but it has dissapeared somewhere I must be doing something wrong.

My husband was on an apo pump and has used the pen jects and it worked very well for him for fifteen years, we were able to go out more and it got rid of the on/offs and smoothed out his days.One of the first symptoms of it working is often to yawn quite a few times, so once you start that you know it won't be long to get the relief you want. My husband was on it 24hours in the end before he started having problems but don't forget he has had pd for thirty years so he has been on a lot of medication for such a long time. I am suprised they didn't try apo before suggesting the DBS but they all have their different idea's.
I wish you well which ever you choose to do and as already been said don't forget it is also a D/A, but for my husband it was a good move.
best wishes
vivian

#4
Apomorphine is a very interesting drug. It is, as far as I know, the only DA that works on D1 and D2 type receptors. Other DAs are mainly or entirely D2. There is some reason to think that the imbalance between D1 and D2 leads to OCD as D2 tends to be involved in the reward system. Apomorphine should, and does, act more like ldopa. However there are reported side effects of increased libido though I haven't come across gambling problems (anyone had those with apomorphine?).
And of course it is an extreme emetic without anti-emetics- hence you dont swallow it.
DBS probably has less side effects and works all-day and not just for a few hours. In the long run it might even be cheaper, more convenient and more tailored. Personally I think I would probably opt for the surgery given the choice (not a recommendation, just a forecast).

#5
:fearful:What's a DA and an OCD . jonta .

#6
DA - dopamine agonist
OCD - obsessive compulsive disorder
TMA - too many acronyms (for pedants - i know these arent really acronyms!)

#7
:grin:Thanks Turnip :)