On Thu 27 Apr, Hans van der Genugten wrote:
> -----Oorspronkelijk bericht-----
> Van: W M <[log in to unmask]>
> Aan: [log in to unmask] <[log in to unmask]>
> Datum: donderdag 27 april 2000 16:08
> Onderwerp: Sinemet dosage
>
>
> >> the doctor informed him that he is getting quite stiff in his
> right arm (the right arm is the arm that shakes quite a bit); and therefore
> wanted to change him to 50/200 CR Sinemet. <<
>
> >> I believe this is a time-release Sinemet? <<
>
> Yes.
>
> >> Well, the last 2 days my Dad has been following the new medicine
> schedule (5am and 4pm); and when he is sitting his right arm is shaking much
> more than ever. <<
>
> See my reply to Lanier in one of the last days: the higher dose can give
> relaxation of stiff muscles which can give an (in most cases temporary)
> increase of the tremors. These tremors were first suppressed by the stiff
> muscles.
>
> >> Also, he hasn't slept much at all since changing the dosage. <<
>
> Higher doses always can cause sleepproblems.
>
> >> According to the info that came with the drug; it may take several weeks
> to adjust to this medicine; etc. <<
>
> To see the stabile result you need to use the higher dose 4-6 weeks.
>
> Hans.
>
>
>
I can hardly believe my eyes as I read this e-mail !! It must set new
records for under-dosing. Is it true that your doctor has prescribed
one Sinemet CR50/200 at 5am and one at 4pm ?
If this is true, what does he suggest you do for the remaining 14 hours
when the tablets have done their job and have been flushed out of your
brain?. The point I am making is that the effective duration of a
Sinemet tablet is determined by factors completely outside your control,
such as the design of the tablet, the efficiency of your digestive system
and no doubt numerous others. The nominal life of a CR tablet (as I have
measured it on myself and several others) is 4 hours. Let's be generous
and say it is 5 hours. That leaves (as I said above) 14 totally unmedicated
hours each day.
I suggest that you get a sheet of paper and mark off 0 to 24 hours along
the X-axis. Mark the points where you take the tablets, add on up to one
hour which is the time that it takes the early tablets
XXXXXXXXXXXXXXXX XXXXXXXXXXXXXXX
------------------|-------------------|----------------|-----------------|----- 0 6 12 18 24
Now work out with your Dad when he gets the worst shakes - That should
make interesting reading.
Regards
--
Brian Collins <[log in to unmask]> (60/39/34)
