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Dr. Frank
Dr. Frank, Board Certified Physician
Category: Neurology
Satisfied Customers: 8999
Experience:  Board certified general Adult Neurologist, with experience in experimental neuroimaging and neurodiagnostics.
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SECOND OPINION PLEASE--79 year old man was on 2 doses of

Customer Question

SECOND OPINION PLEASE--79 year old man was on 2 doses of Sinemet CR 50/200. Dr. tapered it to 1 and a half by cutting evening dose in half for 1 week. Three days ago he was taken of the med completely. He is sleeping a lot.Is sleepiness, lack of energy, and drowsiness a symptom of Sinemet withdraw?
Submitted: 7 months ago.
Category: Neurology
Expert:  Dr. Frank replied 7 months ago.
It could be. Sinemet can give you "pep" or increased energy. You can get "obsessive" like activity such as gambling incessantly, or fixating on a certain act. Sleep is not usually associated with withdrawal, but a lack of activity may precipitate more sleep indirectly. I would still make sure he doesn't have a fever or something like a urinary track infection or respiratory infection if he has moderate to severe parkinson's. Is he on any dopamine agonist medication as well, such as Mirapex or Requip? Please get back to me if you have questions and I will reply. Or if satisfied with this answer, please remember to rate this service by clicking on the rating stars, as that is how I am compensated for this work thanks *****
Customer: replied 7 months ago.
He has been on Zoloft for 2 month due to depression. New doctor took him off of Sinemet because he was not responding to it.
Expert:  Dr. Frank replied 7 months ago.
how much Zoloft? I assume you mean he took him down on his sinemet because he wasn't responding to the zoloft, correct? In that case, if it has only been a few days, it could be the extra serotonergic effect of the zoloft. Dr Frank
Expert:  Dr. Frank replied 7 months ago.
what I wanted to say is that it could the the sertraline (Zoloft) making him sleepy now that there is less Sinemet around
Customer: replied 7 months ago.
No, new neurologist took him off Sinemet because he was not responding to Sinemet. There was no change when Sinemet was increased nor decreased. Physically he was the same.Zoloft was prescribed by GP for his depression
Expert:  Dr. Frank replied 7 months ago.
Hopefully I am helping here. If he is not responding to Sinemet, then it is possible that he doesn't have parkinsons', did the neurologist mention that? Sinemet really should improve parkinson's patients, the only problem is that if use too early, you can precipitate the decline of the disease. So if this was a new diagnosis, and he is not responding, maybe there is something else going on (?), does he have cognitive impairment? Could this all be "pseudodementia" or a neurovegetative state related to severe depression? Dr Frank