Pam Dalby ([log in to unmask])daughter of Ardith 74/+9 wrote:
<<I have noticed that when the end of a 3 hour Sinemet cycle is up, my mother
comments she needs more medicine. She is becoming stiff but still can move.
However she feels uncomfortable inside. Then when she gets the medicine,
she sometimes complains of headache and feeling woozey and "terrible" for 45
minutes or so. She often lays down and falls asleep 10-15 minutes. Is that
the addictive nature of the dopamine making her feel like she needs medicine?
Do others of you experience that problem after you take Sinemet? She takes
25/100 Sinemt with .25 Permax at one time. I feel so helpless and hate to see
her suffer.>>
My feelings as available dopamine subsides are slowness (foot dystonia if
too long without more).
After taking levodopa with no food, there is continuation of end of dose
effect(s) until some levodopa reaches the brain portion in deficit. This
may take 45 minutes. The stomach samples it's contents continuously and
considers levodopa (and dopamine if there is conversion) toxic - creating
the nausea or wooziness which can be severe ("terrible"). Most of this can
be avoided by eating a small amount soon after the meds - a couple of
crackers and a prune perhaps - or popcorn or multigrain Cheerios or other
cereals. This will also help pass the meds into the small intestine where
they can start the trip to the brain by getting into the bloodstream. I
believe that drinking a half glass of hot/warm water ten minutes after
eating can bring some of the dissolved levodopa most quickly into the lower
intestine (somewhat as the pre-dissolved "liquid" Sinemet functions).
I also conjecture that lying down improves the feelings because the brain
blood pressure is higher when prone (or inverted as Pat Schark noted). I
try to get my first pill upon first awakening if that is an hour or less
before I want to start my day. this allows me to go back to bed and often
to sleep - and avoid the dystonia of the overnight meds depletion.
"Addictive" definitions and determination may connote differently in
medical, legal, and general usage but I do not find using that word "fits"
the situation of sensing that one's mental wishes are only slowly carried
out by the formerly well-coordinated muscles and neural networks of the
"motor system". It is more like running out of gasoline or sometimes like
having the cylinders not keeping their cycles properly timed and locking up
by all firing at once.
Mary Ann repliied to Pam:
<<Pam, I'm sure others will post that Sinemet has *terrible* side effects.
My husband is the most stiff when he is 'going up' and Sinemet and
'coming down.' Those are the times when he cannot move at all. He also
falls asleep when his med takes effect. Since my husband only takes
Sinemet at night, this reaction could not be constued as a sign of
addiction.>>
I do not understand what Mary Ann is writing. The side effects of levodopa
are not "terrible" except for the eventual dyskinesia that offsets the
benefits of the replacement/supplying of dopamine. The nausea is usually
eliminated by following the medicine with food. The lack of dopamine (end
of dose or drug "holiday"/termination of intake) effects are not related to
levodopa.
If Mary Ann's husband only takes Sinemet at night, he is the only person I
know of who follows such a medication regimen.
Hope this was worth your time to read.
ron 1936, dz PD 1984
Ronald F. Vetter <[log in to unmask]>
http://www1.ridgecrest.ca.us/~rfvetter/
