Hello Barbara,

Mon, 25 May 1998 16:00, Barbara Duffin-Bates <[log in to unmask]>, wrote:

>My husband  (aged 57, PD 14 years) takes only sinement and
>eldepryl.  He takes 3 100/25 tablets each day, broken in half,
>each dose taken 2 hours apart.

A) Compared with other PWP for 14 years a relatively low dose.

>He has always had a difficult time smoothing out his dosage
>levels.  He will peak about 1 hour after taking a dose, be "on"
>for maybe 25 minutes, then be off again.

B) Peaking after 1 hour is normal with CR, but 25 min "on" is short.

  A + B together suggest he might be UNDER-medicated, however....

>When he is off, he is very slow and stiff but at least he is
>relatively safe.  When "on", he is very diskenetic and often
>falls, sometimes badly.  He NEVER falls when he is off.

C) ...........dyskinetic when "on" suggests he is OVER-medicated.
D) falling can have several reasons:
   1) caused by the dyskinetic movements he looses his balance
   2) caused by side-effects of the Sinemet (e.g. dizzyness) or of
      the eldepryl, or the combination of these two.
   3) caused by low bloodpressure and/or static hypotension (= a sudden
      going down of the bloodpressure after getting up from lying down or
      standing straight after bending over).

>I was wondering if anyone else has noticed this phenomenon
>of falling only when on.

E) you didn't mention a tremor. No tremor can mean he might have
   Parkinsonism instead of classic PD.
   I know several PWP, who have Parkinsonism. They fell a lot when
   they were using medication(s). After they stopped taking the meds
   the falling stopped (after a few weeks).

>I might also add, for those interested in amantadine, Iain did
>try this some years ago.  He said that he did feel better on it,
>but it made him hallucinate.  That was not much fun and we
>took him off.

Concluding: your husband is feeling better in the periods he takes no
            meds than in the periods that he does take his pills!
            Being stiff seems to be a better choice than frequently falling.

My suggestion would be:
1) consider the possibility of Parkinsonism.
2) consult your neurologist and discuss a try-out-period of 3 months
   without meds (or first 3 months without one and than 3 without the other)
3) if that doesn't improve the falling or worsens his other symptoms,
   consider switching to other meds.

IMPORTANT: Don't take my word for it! I'm just another PWP puzzeling
           along. Always consult your neurologist before making any
           changes in your meds!!

Greetings,  Hans.  44/dx5/eldepryl.