I'm not sure, but I understand that dopamine is needed at numerous sites
outside the basal ganglia, including the  peripheral system-   too much
carbidopa in the usual sinemet formulation deprives them.. I think that
is why they have Sinemet 10/100, for example,  instead of  25/100. To
repeat, this is just a guess.
Cheers, Joe


J. R. Bruman (818) 789-3694
3527 Cody Road
Sherman Oaks CA 91403


On Thu, 17 Oct 1996, Camilla Flintermann wrote:

> We've been trying to get a med routine that will help Peter with the
> awful lethargy he experiences at many times through the day. About 6 weeks
> ago the neuro put him on 6XSin>CR 50/200 at 4 hour intervals around the
> clock--no improvement.  Today I went armed with info from this list re:
> CARBIDOPA, and when I suggested that 300mg x day was too much, he agreed, said
>  "that's what I might have said myself" (but of course he DIDn't say it first)
> and agreed to move P. off the CRs and try 25/250mg Sinemet instead. He
> suggested starting with 4 x day, but said we could go to 5 or 6 if needed,
> and still be at 1/2 the carbidopa P. gets now.  To my question about toxicity,
> a point Alan Bonander made on the list, he shrugged, and said there's no
> evidence of that, it's just that you don't*need*more than 70-100mg carbidopa.
> This leads me to ask if anyone has evidence to cite about toxicity? Or is it
> one of those "possible" things we so often encounter with PD? I'd appreciate
> any leads you can give--we're gradually"educating"this neuro, Peter thinks--
> but he doesn't do email---yet! He listened better today than usual, perhaps
> because he had a med student observing in the interview?
> Camilla Flintermann, CG for Peter,78/7 Oxford,OH
>