Safinamide vs Rasagiline
Hello,
I am 75, in good physical shape. I have had PD for 10 years now.
I have been using Levodopa/Carbidopa (LC) as my main PD medication with Entacapone, plus Rasagiline.
This was enough until recently to cover my tremor, balance and gait issues.
However, lately the last hour of the 4-hour interval covered by a dose started to not be covered enough by the above medication, and I had my 1st serious fall at tennis, which led to the luxation of a hand finger, produced as a result of a gait shortening event. Normally, I am waming up for half an hour, including with foot work exercises taken from this link of a tennis pro. Hovewer, I think that my warmup was shortened on that day, which led to the fall. BTW, ahead of each 1-hour long tennis session, I take one extra dose of LC. If I am ot doing that, my gait shortening troubles appear earlier.
As a result of describing these events, my PD doctor then recommended to switch (after a 2-week break) from Rasagiline to Safinamide 50 mg, then to 100 mg a day. It is hoped that Safinamide to be more efficient in distributing LC in time and I covering the balance and gait issues.
I started to go to the Web on these two meds. I am posting in the following what I found, perhaps it will help others. I am now in the 2-week break with no Rasagiline or Safinamide, so I have’t yet started the Safinamide.
My PD doctor and the Web made me aware that Safinamide might be more efficient than Rasagiline, but seems to have more side effects, so I‘m trying to learn more about the effects.
Do you have any experience with Safinamide? I’d appreciate your comments.
I found:
Safinamide MedlinePlus Drug Information
at
https://medlineplus.gov/druginfo/meds/a617025.html
Rasagiline MedlinePlus Drug Information
at
https://medlineplus.gov/druginfo/meds/a606017.html
Then I performed a Google search on
safinamide vs rasagiline
The first two results are two studies from the NIH:
Switching from Rasagiline to Safinamide as an Add-On Therapy Regimen in Patients with Levodopa: A Literature Review
at
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9954438/
Switch from rasagiline to safinamide in fluctuating Parkinson's disease patients: a retrospective, pilot study
at
https://pubmed.ncbi.nlm.nih.gov/34142645/
The first is a recent (2023) literature review with a full text freely available.
Best of health to all of you.
Jerry Thank you for sharing this valuable information with the community. It will be very helpful for anyone facing a similar decision. We are all here to help one another and share what we learn.Thank your for doing so. Thea DeStephano Community Team Member If anyone is interested, the tennis footwork exercises I mention in the original post are shown in
Deigo Schwartzman
at
https://www.youtube.com/watch?v=GlI3s4h3ntY
BTW, for the purpose of improving one’s footwork, the part after 3:40 is more relevant. Schwartzman is a former top-10 player in the world, thus you can be sure you are looking at a quality execution.
The readers in this forum may be interested by the fact I am using parts of these exercises not only for tennis, but also at the beginning of some of the 4-hour intervals covered by a meds dose, esp especially if I feel slow or awkward in walking, or I am facing a gait-shortenings event. These exercises seem to benefit the body by “warming it up,” and to produce a temporary supplement of dopamine, which helps motion.
However, as far as I have understood from lectures on dopamine such as the remarkable
Controlling Your Dopamine For Motivation, Focus & Satisfaction | Huberman Lab Podcast #39
at
https://www.youtube.com/watch?v=QmOF0crdyRU
by Andrew Huberman, the supplementary physical activity may result in a relative deficit of dopamine in later time intervals, for which you may have to compensate by an extra dose of meds, which I am taking – of course, with the approval of my PD doctor, either before or after the extra physical activity.
Best of health to all of you.
