"Stan R. Houston" <[log in to unmask]>
wrote in part:
<<<I have the "Gait-Related" Parkinson's. Have nev
snip
began taking one 25/100 Sinemet pill three times a day with meals (about
6
hours apart). During the nearly six years that have passed, I have
changed
doctors and have increased the Sinemet dosage gradually so that I can
remain
functional most of the day. For the past eight months, my Sinemet dosage
has
been: two and one-half  25/100 tablets at breakfast and lunch and two
25/100
pills with dinner. That usually covers me from approximately  7:00 or
8:00
a.m. until about 10:00 p.m. Some days, late in the afternoon,  I have a
gap
between when the lunch pills wear off and when I take my evening pills.
Of
course, there are those wonderfull days when the Sinemet takes four or
five
hours to kick in.>>

the use of 2+1/2 25/100 carbi/levodopa tablets at breakfast and lunch is
not as good as using one 25/250 tablet. because of the reduced carbidopa
- and the lower cost.

taking levodopa with meals is less effective than taking it with a
relatively empty stomach and following the med with a small amount of
orange juice or a prune or a few mouthfuls of cereal/bran, then a small
amount of low protein (non meat) food about 20 minutes later.

I recommend that you ask your doctor to have you try a more "level"
dosing to reduce the peaks and raise the valleys in the amount of
levodopa in your bloodstream.  Using halves of 25/250 carbidopa/levodopa
tablets - taking one half upon awakening; the second half at
mid-morning; a third half 30 minutes before lunch; 4th at mid afternoon;
5th 30 minutes before evening meal; and a 6th mid-evening if you have 5
or more hours after the evening meal before retiring.

<<<<About three weeks ago, I got out of bed
one morning and discovered that my early-morning limp had suddenly
turned
into an early-morning quick step and falling problem (propulsion). I
could
barely walk. My doctor suggested I try taking one time-release Sinemet
CR
(50/200) at bedtime. So far, this has worked. The pill does not kick in
until
about 5 hours after I take it. When I get up at 5:00 a.m, it's still
working,
so I have the freedom of movement I need to shower, dress and get ready
for
work. Unfortunately, that brings my total 24-hour dosage of Sinemet up
to 900
mg. That concerns me, but I don't know what else to do. So far, I have
not
developed any serious dyskenesia problems, although I realize that is a
possibility.  Anyone had any similar experiences? Anyone have any
suggestions?>>>

the 25/100 Sinemet CR will have nearly the same action-profile (peak
levodopa at about 2 hours after taking and down to about 25% of peak
level after about 5.5 hours), but is less medication - and may let you
sleep better. More than 100 mg. per day of carbidopa may hinder
peripheral neurotransmitters or cause other detrimental effects (Pat
Martin message re biochemistry).

<<<PROBLEMS: Main one is depression, which I believe is drug induced.
Some days, late in the afternoon, I sink into a deep blue funk if my
lunch pills wear off before dinner. A period of depression and paranoia
follows for about an hour. When I feel an attack coming, I usually curl
up in my recliner, turn
snip
allows me to sleep at least four or five hours. Of course, that means
I''m
awake at 3:00 a.m., playing with my computer, watching movies from the
satellite dish, reading, or rearranging books, videos or furniture.>>

I doubt that your depression is drug induced.  as you note, late in the
afternoon - pills wear off.  THAT       is the problem!  You are
under-medicated then - and that is a return to being parkinsonian -
which is depressing.  It is loss of functionality because the brain is
not able to keep up with the body's need of neural message sending. The
half as much twice as often advice solves this problem.

<<FOR BRIAN COLLINS: I am very interested in seeing the "user guide" for
taking medications in the optimum configuration. Unfortunatately, I
cannot get into your files using the URL address you gave on October 27.
Can you communicate it some other way? Or  tell me the secret for
getting into the address through the Internet? Thanks.>>>

I am helping Brian help any of you by having the "sub-pages" that
describe the program and data that the subject who wishes to have Brian
do his analysis must prepare and send to Brian.  Does your statement
that you cannot get into the URL mean that you have no web browser
available to you?  Or, does the statement mean that your attempt using a
browser did not work in opening the URL?

Some discussion and charts that I prepared to provide access to all to
show Bob Naylor's data and graphical addition of medication from
multiple doses during the day are pertinent - these may be found as the
last sub-page you can go to from the Parkinson paragraph which is the
first thing on my home page. The URL is the last line of my "signature".
--
ron      1936, dz PD 1984  Ridgecrest, California
Ronald F. Vetter <[log in to unmask]>
http://www.ridgecrest.ca.us/~rfvetter