What are DA's


#1

 

Hi 

I'v read a few times about DA's could someone out there tell me  what these are and what do they do? Thanks

regards Sugarplum


#2

DAs are dopamine agonists. As far as I know, there are several types. I'm not exactly sure how they work but they either replace dopamine or make your brain create more of it.


#3

Hi sugerplum,

This page on our website has some information on Dopamine agonists:  http://www.parkinsons.org.uk/content/dopamine-agonists

Hope this helps.

Best wishes,

Joanne 


#4

To some they are a mid life crisis x 10 combined with ocd / icd disorders they are behaviour changing and can destroy relationships and put you out of pocket by a hefty sum

To others they are the best fun they've ever had

Some say they arent affected at all. What they mean is they are really but they dont want others to know.

Out of 50 people I know personally who have taken them 44 admitted to behavioural issues that affected their lifestyle. The actual effect is subjective to your life and circumstance. If you are a heavy gambler or into swinging for example you may not notice any particular change. Some have problems with online games etc. or you may find you become obsessive about a hobby or very impulsive. If you are doing unusual things with no plausible reason its likely a side effect and you need to come off them.

Doses as low as 8mg requip or 2.1mg mirapexin have been known to cause significant changes in behaviour.

Maximum dose is 24mg requip  3.14 mg mpex = 4.5 x 0.7mg tablets; dont exceed the dose. (mirapexin leaflet used to have a rider saying your dr could exceed max dose but that has long gone.)

The higher the dose and the longer you are on them the harder it is to come off them and the more likely you will have a permanent behaviour change. This is not necessarily bad but it is likely; risk taking is a common behaviour change, any loss of fear may stay with you.  

Coming off them can cause irritability and depression, stopping them abruptly for a length of time can make you seriously ill or kill you                                                                                                                                                                                                                                                                                             On the plus side they stop some muscle pain and can help with depression.

They arent as good as levodopa and the time they keep you off it is usually 2 to 5 years       

If I had my time again I wouldnt touch them.  Dyskinesia was a big fear with levodopa and still is, I believe it can be managed better and is a better drug all round.


#5

Hi Lether,

 

The last time I came  across statistics for the development of obsessive compulsive disorders, the figure was seventeen and a half percent.  Have you a reference  that everyone develops compulsions to a greater or lesser extent which is what you seem to be saying if I am reading you right.


#6

Hi Eilleen

There are a number of surveys which have various outcomes 10% 25% etc.etc

IMO they are meaning less because;

A. The side effects are varied not just OCD but ICD, novelty seeking, risk taking etc hence I prefer behaviour changes.

B Some side effects like hypersexuality and gambling are not divulged due to embarrassment'

C The patient is addicted to the side effects and wont admit a problem.

D Behaviour is subjective, some changes may be undetected because they don't appear to disrupt the patients lifestyle. Circumstance plays a big part too.

My figures are based on pwp that I have met or I know to be real people and who have behaviour changes and have admitted them through conversations and posts.

The nature of the side effect is not guaranteed it can eg it can be gambling in the form of roulette with large sums of money at stake, or playing online games, Even the most unlikely pastime can become a problem when subjected to the side effects of DAs,  OCDs can become an issue that affects a relationship or employment, for example.

Denial is rife in my experience and it usually takes a while to gain trust of an affected person.


#7

I agree with everything Leyther says.

Our experience has been of horrific damage to family relationships, health and finances.

The figures in the widely accepted Mayo Clinic research published about 2011 are....

1 in 4 patients on a therapeutic dose of DAs and I in 3 men under 50 suffer catastrophic OCDs mainly gambling and hypersexuality.

As Leyther says, probably higher as patients don't admit to it until they have lost everything.

Many successful legal cases against the drug companies around the world but not in the UK.

GG

 


#8

The article was published in 2010 not 2011

http://www.news-medical.net/news/20110325/Parkinsons-disease-drugs-may-lead-to-impulse-control-disorders.aspx

Excerpt...

The study found that the higher the dose, the greater the likelihood of an impulse control behavior. "One in four patients who were on a medium therapeutic dose of the medication had an impulse control disorder," Dr. Hassan says. "For patients who were taking a higher range of the medication, about one in three developed an impulse control disorder."

I think they later added the bit about men under 50.

Take care

GG


#9

I am quite open about my condition.  When asked, I hold nothing back,  I tell the world about my state of affairs in my blog www.wpgchap.blogspot.ca in which I have had 43,300 page views, and one of the things I make clear is I have never had a side effect from mirapex (a DA better known as pramipexole).  I take max dose daily.

However, it is true that the DA's can cause serious problems as described by Layther but not everybody gets them.  I was diagnosed in early 2011 and started maximum does of amantadine and myrapex immediately. The two drugs together suppressed all of my symptoms, except my voice which is low and my ability to word find when speaking.  But these are not caused by drugs. they are just a couple of the little joys of PD.

No side effects at all.

I know, that at 69 years old, I am one of the lucky ones.


#10

wpgchap2

Thanks for your views which are appreciated. 

If DAs work for you and no problems then that's great.

I was 40 when I started using Mirapexin, I was vastly overdosed but I had behaviour changes before I exceeded the maximum dose.

Maybe age is relevant to side effects.

I don't think enough effort is put into comparing those who are doing well with their PD and those who are not. Successes should be investigated and best practises communicated to medical staff and patients.

L