To John and Brian and all listmembers.

John, you describe exactly the same phenomenon that was described in the Quote
of my mail of 31 May: Change of meds schedule. You symptoms seem to
be of the two phase kind. About two months ago this topic has been
discussed on the list. A short Quote about it is added to this mail. The
dyskinesia that you experience when the med's start to do their work
and again after they stopped to do so, is described shortly in this
quote.( You can find more on the web. If you wish I can send some more,
ask me) However, one thing you mentioned is exceptional. Your first
diskinesia period of the day is unusual long. This dyskinesia of yours
seems to be a hybrid. It has attributions from 'peak of dose' dysk.(the
length) and also from 'start of med's' dyskinesia (it stops when the
med's are still on their max.)
My first period of dysk. starts too about one hour after the first intake,
but it lasts never more than 10 min. In the litterature about DID
reactions the 'start of med's' dysk. is of short duration.
Nobody can explain the mechanism that causes this pattern of
symptoms. It is of course possible to picture some mechanism in which
the l-dopa in our brain can trigger a different reaction in different
dopamine receptors and those reactions need different levels of dopamine
to be triggered and one reaction can overrule the other.

The complexity of the brain is beyond intuitive perception abilities.

The brain is sometimes conceptualized as some sort of computer, though
a very complex one. However,it seems more adequate to consider many of
our many [10 to the 12 power] nerve cells as computers themselves, because in
fact a nerve cell is a place where hundreds or thousands of other
cells bring there message. All those messages have to be processed.
Some are excitating, some are repressing and some are excitating the
repression and vice versa. Some have short term- and other long term
effects, making cells hypersensitive or the opposite.
We know much about what the brain can do, but often don't have the
faintest idea how.

BTW If I had your syptoms I would experiment a little with the first dose,
trying to take a little bit less. But maybe you did that and maybe it
makes the symptoms worse. I would too try to take the last dose at 14.30

BTW2 is your dyskinesia going together with dystonia?

QUOTE
The dystonic dyskinesias are also seen in a second distinct pattern, in
which these adventitious movements occur just at the beginning and again
at the end of the levodopa response cycle. This has been termed "diphasic
dyskinesia" or D-I-D response, a shorthand for "dyskinesia-improvement
-dyskinesia").This pattern is much less common than peak-dose dyskinesia
and is often difficult to diagnose because the pattern may not be
obvious, either to the patient or the clinician, The end-of-dose period of
dyskinesias is typically more prolonged and troublesome than the initial
dyskinetic period of the levodopa cycle.


                                  Ida Kamphuis, 53/12+
                                         Holland


>>>>>>>
2-6-97 13:37, in bericht <[log in to unmask]>, John Davis
<[log in to unmask]> schreef:

To: Brian Collins Subject: End of dose Dynskinesias
I would like to resurrect this subject which was discussed several days
ago

I practice what you describe as " overdosing" by taking 2 CR-Sinemets
first
thing in the morning, then maintaining that level throughout the useful
part of my day. I usually take 2 50-200 at 7:00 AM,  1/2 25- 100 and 1
50-200 at 11:00 AM then same again at 3:00 PM. This usually keeps me in
good working order through the lunch period,however, by 1:30 I am sensitive
to stressful situations and by NLT 3:30 I will have a period of dyskinesias
before my 3:00 PM dose of medicine kicks in.

By 7:00 PM the Sinemet wears off and I usually go through the period of
dyskinesias you describe at the end of medication.

What I cannot explain is the period of dyskinesias that I go through with
my first dose in the morning.  If  I take(2) 50-200  Crs at 7:00 AM, I
will have a period of dyskinesias starting at about 8:00 until about 8:45.
Then by  9:00 AM it will take effect and I will be fine  for the rest  of my
normal day. I'm sure that I am not unique in experiencing this although I do
not
recall seeing any discussion about it.

Regards

John Davis
>>>>>>>>>