On Thu 13 Aug, Debbie White wrote:
> I wrote last night because my mother Joyce (68/1 year) is having a tough
> time right now and her doctor suggested that she may have some other
> Parkinsonian disease. After receiving reading some informative pieces
> suggested by some on this list, it seems to me more and more that she has
> PD.
>(snip)
>
> What I think is confusing the issue is that my mother doesn't (never has)
> have clear on/off periods. However, I don't think one can conclude from
> this that the drugs aren't working. So my next question is: Isn't it
> possible to say the drugs are working without feeling them kick in? Any
> thoughts?
> Debbie White
> [log in to unmask]
>
>
>
hello Debbie, I remember well the time whwn you joined us and had us running
in circles trying to understand your mother's stmptoms. Sadly, I can only
conclude that she has one  of the more rapidly degenerating varieties of PD.
because of the unexpectedly high dosages of drugs which she has tried.

But let's take a deep breath and think about it; in particular the business
of switching off and on. In my long experience, noticeable switching (say
less than 5 minutes from heavily off to noticeably on has only come to bother
me in recent years: I would not really expect a 1 year ( or even a 5 year
PWP) to even know what we are talking about.  (one point I should clarify
is those unfortunate people who have been told to take a large dose of
levadopa in the early morning to 'Kick Start' their system. Of course they
will detect a noticeable off/on effect, because they are rushing from
underdose; right through the control point ( the place they should have
aimed for), into a heavily overdosed condition.  I now have abstracts from
2 or 3 recent papers which are coming round to the conclusion that forcing
levels of levodopa  above the minimum required can cause more
'wear and tear on the Dopamine system.      .

The 'soft landing 'of early stages PD is explainable quite easily: It is
due to the one thing which we know fairly well, that a newly diagnosed PWP
has (about) 20% of his/her Dopamine-producing cells intact and functioning.
It takes a LOT of levodopa to overwhelm that 20% of 'normal cells.

What I am suggesting, Debbie, is that it may be worth going back to minimal
or no doseage of any Parkinson's medication for 48 hours (Not a pleasant
prospect, I know), and starting afresh.
What do you think?

Regards,
--
Brian Collins  <[log in to unmask]>



--
Brian Collins  <[log in to unmask]>