Over the last year, I have mentioned my Vyalev pump many times. Overall, my experience with it has been very positive. Ultimately, the Vyalev pump only provides a continuous liquid supply of carbidopa / levodopa (Levo). I.e., it just replaces the Levo pills I had been taking several times a day. But the steady stream makes EVERYTHING better. Any time I switch back to the pill form, life is worse. In fact, I do *so* well on the pump, that both my Parkinson’s specialist and my Cedric wondered whether I might be able to reduce some of the other Parkinson’s medications I’d been taking. So, over the last few months, I tried weaning myself slowly off one drug at a time. Here’s how that went.

Pramipexole:

This was the first (and for a few years, the only) drug I was prescribed for Parkinson’s Disease (PD). Just before I started using the pump, I had been taking 11 (yes, eleven) 0.125 mg Pramipexole (Prami) pills each day. For a complicated set of reasons, I decided to start by reducing the Prami from 11 pills a day, to six per day. After about a week, I seemed to be doing well, so I reduced the Prami to five pills per day. Things then got worse. I had significant increases in anxiety, so I bumped the Prami back up to seven a day. I seemed to stabilize at this dosage, so I moved on to the next med on my list…

GoCovri:

Before I started using the pump, I had been taking two 137 mg GoCovri pills each day. I reduced this to one pill per day. After a week, this seemed to be going well, so I stopped taking the GoCovri. I can’t really remember what happened next, so I consulted my notes for that time period. Unfortunately, the only thing my notes say is, “Went nuts.” In response to this event, I returned GoCovri to its original status as two-a-day. However, I was still experiencing too much anxiety and decided to re-up the Prami.

Pramipexole (again):

I bumped the Prami back up to eight pills a day. After a week, there was still too much anxiety, so I bumped some more. I have since stabilized at nine Prami a day.

Conclusion:

The Vyalev liquid Levo approach is vastly superior to the old-school pill-based Levo approach. But that’s it. It simply replaces pills with liquids. For me, it did not replace any other meds. It did seem to allow a slight reduction in my Prami intake (from 11 pills a day to nine a day), but it was not the reduction I had hoped.