On Fri 13 Aug, Ida & Andre Kamphuis wrote:
> Brian wrote:
>

> If I do understand you well, you say diskinesia is allways caused by a
> surplus of dopamine. Wearing-off dyskinesia is im your model not caused by
> a diminishing level of dopamine but also by a surplus in disguise. You say
> wearing off dysk. can be prevented by not taking the last dose. If I skipp
> the last dose, the only effect is  the wearing off dysk starts about 4
> hours earlier. If I make my interdose times longer, I do have dyskinesia in
> every interdose time.
> That has happened years ago when I too thought dyskinesia meant to much
> dopamine and I tried to lower my intake. If the wearing off dysk. is there,
> I have the choice between waiting till it stops or postpone it by taking
> another
> dose of leva-dopa. To stabilise my leva-dopa level  24 hours a day is
> impossible, because of overdose dysk. which will destroy all the profit
> leva-dopa gives me. ( I do use now 3,75 mg each day (+12mg Requip).
> So your model fits for your symptoms and for the symptoms of most PWP's,
> but not for my symptoms and the symptoms of a minority of PWP's.
>
> Regards
> Ida

Hello Ida, There is no doubt that you are exceptionally  sensitive to
levadopa. Do I understand correctly that you take 3 tablets per day, of
75 mg each? That is interesting; do the 3 tablets actually give you the
full 16 hour coverage?  The contrast with my dose, which is also 75 mg
but only lasts 2 hours is quite sharp. If you really are 'ON' most of the
time, it suggests to me that there is a deficiency of whatever most
people have to break down  the dopamine ( COMT for example).

The reason why I am so keen to promote the idea of the normal brain
never exceeding a certain level of dopamine is that it makes way for
such a simple concept to describe the Dyskinesias. It also, of course,
explains why it gets more and more difficult to arrive at the correct
dose of levadopa.  I get so irritated when I read about another neuro
stating that levadopa only lasts 6 to 8 years, after which, phrases
like "response to treatment beginning to fluctuate" and "problems such
as the on-off syndrome begin to occur." I ask every neuro that I meet
how he thinks I still manage to use levadopa satisfactorily after 20
years (together with an agonist for the  last 5 of course), and they
have no answer. They need their best friend to tell them that just
because the smallest tablet available is 50 mg that does not mean
that life stops there and they can only use 50 or 100 mg .

Sorry to have run on for so long.

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