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At 23:01 2000/10/11 -0700, sandy norris wrote: >Hello List Family, >I have a friend with Pd that has suffered with dyskinesias off and on >since 8:00 am. I just got off the phone with her. She has had only two >non-dyskinetic hours today. Here are her stats ... She has been diagnosed >for 4 years, symptomatic for 1 1/2 to 2 yrs before dx. She is on >Sinemet CR 50/200 . She takes 1/2 tablet to get her started in the >morning. The only other med she is on is Requip. She takes the sinemet >morning and early afternoon. But today she has only had the morning 1/2 >tablet...not sure about how much requip she has had..maybe 2 doses..or 3. >My question is...Is it recommended to cut a CR tablet in half? Would >this not effect the time-release capability of the CR? Can requip cause >Dyskinesia? I know that in early-onset and early detection only >agonists are used in order to maximize the dopamine still being produced >by the brain. My heart is going out to my friend. I told her I would >be posing this to the list..Any opinions, suggestions and Rph input >would be very much appreciated. >Sandy Norris 40/28/20 hi sandy how long has she been taking levodopa? how long has she been taking requip? at what dosage levels? why is she not sure how much she has had today? has she called her neuro in re her dyskinesias today? has she had dyskinesias any other time prior to this? the dopamine agonists do not cause dyskinesia directly; the dyskinesia is caused by too much levodopa in a sensitized brain; the increased level of available levodopa is a direct benefit of the agonist if one adds a dopamine agonist to an existing levodopa regimen, one must anticipate reducing the levodopa dosage as soon as dyskinesias appear; i would hope that her neuro advised her of this probability i remember when mirapex [pramipexole] was first introduced; many patients were **not** told to expect to reduce their levodopa by up to 25%! communication, education, and titration are the big names in this game! in re cutting sinemet cr [sustained release] tablets in half the more surface area that is exposed, the faster the 'release' will occur, although the 'release' is still 'sustained', just to a lesser degree as far as i am concerned, what works is what is right for the individual [assuming doctor involvement and agreement, of course] i have taken up the custom of 'melting' cr's in my mouth rather than swallowing them whole [a total 'no-no' per the manufacturer] but this way they still have a minor sustained effect and thus give a much 'smoother' result than the instant release sinemet, and i also avoid the indigestion, dyspepsia, and dyskinesia [not a pretty sight!] which always accompany sinemet cr if i take it in the recommended fashion i highly recommend a patient diary for keeping track of med intakes and timings; the DSSE is one such created by our own bernie barber and is available on my website janet no i am not a doctor and no i have never played one on tv janet paterson 53 now / 44 dx cd / 43 onset cd / 41 dx pd / 37 onset pd TEL: 613 256 8340 URL: http://www.geocities.com/janet313/ EMAIL: [log in to unmask] SMAIL: PO Box 171 Almonte Ontario K0A 1A0 Canada