To Alan Bonander

Alan, you're the first one I have heard of using 25/250.
Could you tell me all you know about it.  I have been taking it for about a
month now & find it causes my right foot and ankle to twist inward.  I
therefore had chose to split the pills in half.  At this point I haven't
seen much gain in taking the pill.  Thanks in advance.
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----- Original Message -----
From: "janet paterson" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Wednesday, April 04, 2001 12:33 PM
Subject: gold nuggets from the archives / carbidopa


> >>> Posting number 277
> Date:         Sun, 20 Feb 1994 17:01:20 EST
> From:         Alan Bonander
> Subject:      Sinemet Usage
>
> Dear Barbara, you have most likely received a lot of help concerning your
> trouble with Sinemet.  I thought I would add a different twist to the
> problem.
>
> Just some random thoughts on the use of Sinemet.
>
> The name Sinemet means "without throwing up" or something similar.  This
was
> the major problem with Levodopa by its self.  Adding Carbidopa to Levodopa
> smoothed the "throwing up" center and allowed more Levodopa to cross the
> blood-brain barrier.  There has been various writings about how much
> Carbidopa one needs daily to effectively control the problems and give the
> benefit.  Some famous doctors have stated that between 50 and 125 mg of
> Carbidopa is needed.  Recently it was reported that 75 to 150 mg were
needed.
> Then it was reported that if one takes over 300 mg that Carbidopa crosses
> over the blood-brain barrier and inhibits conversion of Levodopa to
Dopamine.
> All this is very confusing to patients.  So here is my current thinking
and I
> am not a MD.  I have PD.
>
> Carbidopa has some negative side effects.  It inhibits the generation of
> Serotonin.  Now Serotonin is required in the process of making natural
> dopamine in the brain.  What could be happening is, too much carbidopa
could
> effectively cause an OFF result by the process above.  At the same time,
too
> little carbidopa and we start to throw up.  I have found for myself I need
> around 125 mg of carbidopa to maximize my response to Levodopa.  Too much
and
> I have less than optimal response and too little, no response at all.  To
> help the response along I take my Sinemet on an empty stomach.  Taking it
> with food can cause problems as the same with protein conflicts.
>
> I often suggest that if stomach problems result from taking Sinemet on an
> empty stomach, use a cracker or a vanilla wafer cookie, all of which have
no
> protein, and take the pill with orange juice, 7-up or similar sweet fluid.
> If you want to speed things along, put the Sinemet pill in the sweet fluid
> for about 60 seconds and than drink it.  The pill will dissolve and will
pass
> through the pylorus into the small intestine.  This is were it needs to be
to
> enter the blood system, etc.  One warning, this method will send a lot of
the
> medication to the brain quickly.  As a result, you could actually be
> overdosed for a short time.  It is very effective for the first pill in
the
> morning, when one needs an extra boost.
>
> Another consideration for those of you taking Sinemet CR and having
stomach
> problems with the first dose.  It turns out that Levodopa in the CR
actually
> releases faster than the Carbidopa.  The result is nausea, etc.  The
> recommended alternative is to ask your doctor for a FREE drug call
Lodosyn.
> Yes I said FREE.  This is the name of a Carbidopa only pill that is  25 mg
of
> Carbidopa.  DuPont gives these to doctors free for asking.  You can not
get a
> prescription as drug stores do not carry free meds.  Anyway, taking a 25
mg
> Lodosyn with the first CR in the morning seems to solve the nausea
problems.
> I might also add that it takes about two weeks of taking Sinemet for it to
> build to a "therapeutic level" according to one famous neurologist.  Maybe
> after two weeks some of the initial problems go away.
>
> Now I don't know how much added confusion I have contributed to with this
> little bit of noise.  If it doesn't work for you, fine.  If it does work,
> fine.
> Any other comments would be appreciated.  Like a said, I am not a MD.
> I have had PD for 10 years and take about 800 mg of Levodopa, 125 mg of
> Carbidopa, 2 mg of Permax and 20 mg of Paxil.  When I was diagnosed, the
> doctor gave me Sinemet 25/250 and said take 4 or 5 of these a day and you
> will feel better.  I did and I did.  No problems initially, the problems
came
> later when the ON/OFF started.  That is another story for another time.
>
> Alan Bonander  <[log in to unmask]>
>
> janet paterson, an akinetic rigid subtype, albeit perky, parky
> PD: 54/41/37 CD: 54/44/43 TEL: 613 256 8340 EMAIL: [log in to unmask]
> "A New Voice" home page: http://www.geocities.com/janet313/     .
> "New Voice News" latest posts: http://groups.yahoo.com/group/nvnNET/     .
>
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