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^^^^^^ WARM GREETINGS FROM ^^^^^^^^^^^^ :-) Ivan Suzman 50/39/36 [log in to unmask] :-) Portland, Maine land of lighthouses deg. F :-) ******************************************************************** --------- Forwarded message ---------- From: Ivan M Suzman <[log in to unmask]> To: [log in to unmask] Date: Thu, 6 Jul 2000 06:21:28 -0400 Subject: Re: comtan??? Message-ID: <[log in to unmask]> If Jack has. all along, been UNDERmedicated in the afternoon, before this, then he needs the L-dopa in Sinemet. The nurse's instinct sounds pretty good to me, even though the neuro did not talk to you and jackk directly. The Comtan is usually added on , and if it causes dyskinesia, the Sinemet or the Comtan , or both can be adjusted afterwards. Comtan, like Tasmar, knocks out an enzyme called catechol-o-methyl-transferase, or COMT. Thus, it is a COMT inhibitor. Normally, COMT causes excess L-dopa to be used up. COMT inhibitors therefore facilitate the delivery of L-dopa, which is the important ingredient in Sinemet CR and in Sinemet, that is converted by the brain to dopamine. L-dopa is the abbreviation for dihydroxy-phenyl-alanine. The fact that jack improves so much in the morning suggests to me that his Comtan will help him again, if taken in the afternoon with an added dose of Sinemet or Sinemet CR, just like he does in the morning, now. Keep the faith, Connie--what a great carepartner you are!!! I wish I were so lucky...I'm sure Jack knows how fortunate he is. And, keep us posted!! :-) Ivan Suzman 50/39/36 On Wed, 5 Jul 2000 18:02:37 -0700 Constance Tate <[log in to unmask]> writes: > dear list > i am rather upset about jack's neuro and would like feed back > on > this. > we saw neuro apr. and he started jack on comtan 200 units with first > sinemet > 50/200 cr and call back in 2 weeks to see how it worked. it made a > big > difference early in morning. jack's voice became stronger and he > seems to > feel well until midafternoon. he had been taking 25/100 sinemet same > as > pre comtan and 8 pm 50/200 sinemet. > > as the afternoon progresses he is slower and tired. when we called 2 > weeks > ago > and told nurse he was slower she-not the doctor called back a few > days later > to tell jack to add 50/200cr to 50/100 sinemet in afternoon and call > back > again in 2 weeks. well i told our primary doctor about it and she > said she > would speak to > neuro---result today again nurse phoned and said neuro wants jak to > increase > dose of sinemet again---and call back in 2 weeks.maybe at that time > neuro > may want to see how jack is doing. well it seems that all i have > read is > comtam is to help reduce sinemet not increase it. has this > happened to > anyone else? > he has not icreased the comtan so all jack is taking is the one > in > morning > i am puzzled with this and hope you can advise whether this is usual > or not. > perplexed > connie ^^^^^^ WARM GREETINGS FROM ^^^^^^^^^^^^ :-) Ivan Suzman 50/39/36 [log in to unmask] :-) Portland, Maine land of lighthouses deg. F :-) ********************************************************************