On Wed 26 Mar, Donovan White wrote:

>
> When I spoke to her this evening, she was feeling better. Her first night
> taking Permax deprived her of sleep. She decided to take half the dose for
> now.
>
> Her doctor has her taking 16 .25 mg tablets eventually along with the
> 25/100 Sinemet 4x/day -- does this sound excessive to anyone??
>

 was especially troubled by being off balance today. Tomorrow it may be
 better (this has happened before).
 Thanks.  Debbie White

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Hello Debbie,  as you may have gathered by now, I'm not a big fan of the
'day-to-day variation' school of thought. If such variation does exist, I
think it may be because you are nibbling at the edge of the effective dose.

Re: Permax - I was a bit shaken to see 16 tablets of .25 mg each. I take
the same tablets and I started at 2 tabs per day in Sept 94, raised it to
4 per day in Oct 94, and held  constant at 4 until Jan 97 when I raised
it to 8 per day to offset the normal deterioration of PD. I was advised
when I started that 3mg per day (12 tabs) was the sensible limit. That
may have been a bit conservative because the tablets were new, but I
checked last week, and the highest amount that my neurologist has
prescribed is 4mg per day. Going straight in with 4 mg/day for your mother
seems way over the top to me. By the way, my VERY rough estimate is that
4 mg/day is roughly equivalent to taking a sinemet 25/100 every 3 hours !
My inclination is to keep the Permax at around 2mg, and raise the Sinemet
by 1/2 a tablet per dose.

You must be wondering what sort of a treadmill you have got on to, and in
reality it is a treadmill; one that just gets harder as time goes on.
Take heart, however, you are doing all the right things (I wish this
group had been around 17 years ago !
Regards,
--
Brian Collins  <[log in to unmask]>