On Wed 12 Feb, Ivan M Suzman wrote:
>
>
> On Sinemet CR:
>
>        I am posting this to the whole list, hoping that this account of
> how Sinemet CR tends to work in me may be useful information for others
> besides Bill.
>
> ******************************************************************************
>        I think in terms of "How many minutes of relief   will I obtain
> by taking CR tablets?
> And secondly, what quality of relief does each tablet  provide?
>
>        In my body,(as you know, each person has a unique response) one
> 100 mg. Sinemet CR tablet (the pink one) lasts me about 90 minutes.  A
> 200 mg Sinemet CR tablet (cafe-au-lait ) lasts about 180 minutes.
>
>       So, I can think in terms of 0.9 minutes of relief  for each 1
> milligram of CR swallowed.
>
>       However, the 200 mg. CR tablet tends to  give me dyskinesia after
> about an hour. I think that once it starts dissolving, too much medicine
> is hitting me all at once.
>
>    .  So  I  have learned to divide the 50/200 CR along its crease,
> ending up with 100 mg.  This half-tablet still seems stronger than the
> pink 100 mg. tablet.  It also seems, generally,  to last a bit longer,
> maybe up to 120 minutes. Usually, neither CR pill is as strong as the
> effects of the  conventional, lemon-yellow 25/100 tablet.
>
>
>        Both can at times  leave  me slightly undermedicated.  So I have
> to nibble or take bits of a conventional yellow  25/100  along with
> taking the CR, to jump start my body until the CR tablets take over.
>
>       If  Sinemet CR kick in perfectly, it's sort of like a
> cruise-control button in a car.
> You sit back and relax. and go for a  really nice ride.
>
>       Sometimes, the CR  doesn't work AT ALL..  The shiny sealed surfaces
> seem to act like a barrier to the L-dopa  inside  the tablets.  Then I
> feel like I'm stuck in a tar pit, and can never really get free to move
> normally.
>
>        CR is  sometimes helpful to me during the night, and is used up
> slowly enough to help somewhat , with sleeping longer.
>
>        Dr. Abraham Leiberman wrote an excellent and detailed report on
> Sinemet CR about  5 years ago.  IF you call the APDA at 1-800-223-2732, I
> think a copy can be mailed to you.
>
> Ivan Suzman
> Portland, Maine           land of lighthouses
>
Hello Ivan,
            I don't think I have seen a description of the CR tablets put
together in quite the way that you have done it. I am not saying it is wrong,
but I do think that some readers may have got some wrong impressions from
what you have written.  I will try to explain:

You appear to be saying in your first two paragraphs that a 100 mg CR tablet
lasts you for 90 minutes, and a 200 mg tablet lasts about 180 mins. The
inference is that effective time is proportional to the number of milligrammes.
e,g. if you took a Sinemet CR of 400 mg, it would last 360 minutes! Well, the
tablets may last that long, but I doubt if you would be around to talk about
it !
   In fact, the 100 mg and 200 mg Sinemet CRs are both designed to unload their
contents in the SAME timescale. The way that the effectiveness varies is really
due to how your brain interacts with the levodopa.
  I would say that for a person who apparently responds to the output of a 100
mg Sinemet CR CR tablet.  (it does nothing for me, because its release rate is
too low at about 25 mg/hour.), I would expect the output of a double-sized
tablet like the 200mg CR tablet to be unacceptably high, and in fact you do
acknowledge that when you saythat a 200 mg CR tends to give you dyskinesias
after about an hour.  'About an hour' is the length of time for a CR tablet  to
become fully effective, and what that tells you is that the 200 mg Sinemet
tablet is not for you : Its output is too high.
    Breaking a Sinemet CR will give a greater initial 'kick' , because you are
exposing  a greater area to the bunch of chemicals which are busy trying  to
disolve the tablet. Thus it disolves more rapidly, or more like a non-CR type
of tablet.
     I note that you use the key-words 'jump start' and 'kick in', which tell
me that for at least part of the time you are wandering in the "Twilight Zone"
( see my chart C for the explanation of that!)
--
Brian Collins  <[log in to unmask]>