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Suggest The Ideal Dosage For Mirapex

Posted on Tue, 16 Aug 2016

Question: The Mirapex worked for 6 straight days at dose of .25mg. Then it never worked again. We tried increasing the dosage to .5 and then to 1mg but still no success. Only difference with or without Mirapex is that the events are not quite as severe. Anything else I should add to the Mirapex or other thoughts? Thanks SO much.

Answered by Dr. Seikhoo Bishnoi (30 minutes later)

Brief Answer:
Low dose Benzodiazepines can be added

Detailed Answer:
Hi, thanks for asking from HCM

Mirapax is Pramipaxol and the drug is used in a number of neuro-psychiatric disorders. The drug is commonly used in Parkinson's disease, Restless leg syndrome, resistant depression etc disorders. You have progressively increased the dose to 1 mg and there is not much success. In such cases in my opinion there is no use to increase the doses further because this might result in side effects.

Other option is to add low dose benzodiazepines along with Mirapax. Long acting benzos like Clonazepam in low dose (0.25) can help to reduce the symptoms and will help in better sleep. The drug will supplement the actions of Mirapax too. Gabapentin or Pregabalin are other options. You can discuss with your doctor and ask for revised prescription.

Along with this I'd advise you to start Vitamin E and B12 supplements. Low vitamin E in a lot of patients worsens the sleep issues. These are safe and free of any adverse effects.

Thanks, I hope this helps. If you have more doubts please ask again. Take care

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Seikhoo Bishnoi (15 minutes later)

It is extremely important to me that ANY drug I take does not increase chances of dementia nor alzheimers as both parents suffered from same. I have zero symptoms of either at the moment. I am told that Mirapex does NOT have much if any chance of dementia as side effect. How about the other drugs you are suggesting to add to Mirapex. Again, the Mirapex DID work for 6 straight days. That is the FIRST time I didn't have the night issue of throwing myself violently out of bed thinking I was choking in over 4000 days straight. Thus I thought we had the answer. My doctor is sure this is some type of problem very similar to sleep walking since I rarely remember exactly what I did but my wife does. Also I have NEVER hit my head on a side table no matter which side of bed or if I'm in a hotel or other place. Thanks so much for your help. Also wondering why the previous doctor who is a neurologist didn't answer this time. Thank you again.

Answered by Dr. Seikhoo Bishnoi (1 hour later)

Brief Answer:
Avoid benzodiazepines as these might increase risk of dementia

Detailed Answer:
Hello thanks for asking a follow up

I am sorry I answered the query because it was posted via general query. If you want to ask any particular doctor please ask through direct question section.

You have family history of dementia then I would not recommend Clonazepam or any other benzodiazepine to you. These drugs might worsen forgetfulness but dementia is not side effect of this drug in low doses. Still better to avoid this.

You should start Vitamin E and B12 supplements. Vitamin E supplements will result in protection from dementia too. A lot of REM sleep disorders show such symptoms.

Pregabalin or Gabapentine can be used in low doses. These drugs will control the restless legs and will not increase the risk of dementia too. You can discuss with your doctor for that.

Thanks, Take care. Still have more doubts please ask again.

Note: For further guidance on mental health, Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar