Brief Answer:
Explained

Detailed Answer:
Hello and Welcome

I appreciate your concern.

Azilect ( Rasagilline ) is associated with a higher incidence of both hallucinations and depression as compared to Requip ( Ropinirole ).

Requip is associated with an increased incidence of fatigue , generalized weakness and hypotension.

Most Parkinson patients are initially started on Levodopa/carbidopa combination
(sinemet) in the initial stages of Parkinson, but sinemet itself can cause psychosis as a side efeect.

If there are increased episodes of hallucinations , it would be appropriate to treat with Levodopa on its own. Your doctor will always try to balance the lowest possible dose with an acceptable affect on Motor symptoms.

In some cases, such adjustments may not stop hallucinations or delusions, or may mean that other Parkinson’s symptoms are not adequately controlled and so quality of life is compromised.

Finding the right balance between good symptom control and hallucinations can be difficult and if this balance is not found then special drugs, known as Neuroleptic or antipsychotic drugs, may be prescribed to control the hallucinations. CLOZAPINE and QUETIAPINE are two options in this regard which you can discuss with your doctor.

If you felt better with azilect and were only hindered by the hallucinations, then adding clozapine is an option while restarting azilect , in consult with your doctor.
If the hallucinations recur, a psychiatric opinion should also be considered.

Though fatigue is common with requip initially, you should get done CBC, RFTS, LFTS, RBS, ELECTROLYTES to make sure there is no other cause responsible for the weakness that you experience


Let me know if you have any query

wishing you best of health

Thanks

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