Brian, having just started on SinemetCR 25/100 three times a day, what are
your views aboutSinemet vs. SinemetCR?
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----- Original Message -----
From: Brian Collins <[log in to unmask]>
To: <[log in to unmask]>
Sent: Tuesday, November 09, 1999 5:50 PM
Subject: Re: Mirapex side effects / delaying sinemet


> I am in full agreement with Janet on the subject of delaying Sinemet. It
is
> one of those situations where someone happens to start a trend (with
nothing
> to support it, and all the other lemmings surge into action. And 40
million
> lemmings can't be wrong, can they?
>
> In this example of ludicrous logic, I have managed to put together what I
> think is the reasoning  (or should that be unreasoning) which led  to the
> witholding of levodopa fashion:
>
> 1) It is well known that you can't achieve a satisfactory control of PD
> symptoms with Sinemet beyond about 7 or 8 years, due to the dyskinesias
and
> 'motor fluctuations'. I haven't heard a decent definition of Motor
> Fluctuations, but never mind, it must be a really bad place to go.
>   (By the way, I controlled my symptoms quite acceptably for 14 years, by
> a rational and careful application of Sinemet, and have written quite a
> lot about the subject, but I doubt if any professionals have understood my
> arguments.
>
> 2) Here it comes, the giant leap for mankind: The Sinemet would behave
> much better at the 7 to 8 year point, if we avoided using it at all in the
> early days of PD. How? Why? Where is the reasoning? There is none because
> the whole proposition is ludicrous. Have they forgotten that we are
dealing
> with PD here? I doubt that anyone in the world of PD has ever made the
> slightest impression on the rate of deterioration of anyone's  PD symptoms
> (Of course, there is a range of deterioration rates, but each person's
> rate is his own, and there is no changing it.
>
> That rate of deterioration has nothing to do with Sinemet:it is loss of
brain
> cells which is the cause. By the way, I forgot to mention that I took
Sinemet
> alone for 14 yrs, And I took Sinemet for all but the first year of PD, AND
> I still take Sinemet 800 mg/day of levodopa at 21 years since diagnosis!!
>
> Witholding Sinemet in early PD is stupid, and it doesn't work. Of course
> proving that it doesn't work is virtually impossible because you can't go
> back and try again. It has to be done by logic, and I have done that - not
> here, I've just indulged myself by letting off some steam in this e-mail,
> but you can if you wish follow my more rational writings in the following
> web site
>
>      http://james.parkinsons.org.uk/brian.htm
>
> Happy reading,
> Regards
>
> --
> Brian Collins  <[log in to unmask]>