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DEBORAH BELLMAN <[log in to unmask]> wrote <<<In the last week by cutting back on the Sinemet CR and using the 25/100's more, she seems to have less dystonia and more bradykinesia. snip I read some of the survey notes and must add only that there is an intensive need for her to move during those times when she has little to no control over her body. Also, after she eats especially, she has been having fainting dizzy spells. This happens extremely quickly and has had some nasty falls.>>> The reduction of carbidopa may be significant in reducing the dystonia. Going to 10/100 or 25/250 tablets and halves might help further the peripheral conversion of some levodopa needed outside the brain and CNS. The "intensive need for her to move" may be being resisted - this manifesting as extreme rigidity (= high muscle tonus = dys-tonia). I also note symptoms of lower blood volume/pressure during digestion of meals. This hypo-tension is helped by lying prone - or standing on your head/shoulders. I have half-facetiously said that fainting is the last resort method for the brain to get us to lie down. Brian Collins, I too would like to know all about your computer program regarding medicating. I find the graphical data plotting using the data and plots suggested by Bob Naylor interesting and beneficial. Specifically, the time to peak value of levodopa in blood plasma varies as does the decay rate - between the regular meds and the CR versions. The liquid sinemet is the fastest loading of levodopa into the blood and the fastest from mouth to small intestine (I have no plasma concentration data for it, but would welcome such), but it also is shortest in duration and perhaps efficiency. The abrupt rise to a spike peak followed by rapid decay of amount entering the blood stream would make getting actual plasma levels quite difficult since the blood just leaving the absorption (small intestine locus) would have very high concentration with very little yet dispersed in the total amount of blood throughout the body. The regular medication is somewhat similar but the peak is much lower and the time duration longer. The CR dissolving is slow and there is not a spike. The data Robert Naylor generously supplied to me shows a more gradual rise to a rounded or mesa (flat) level the slower rate of decay in concentration. The plots can be useful in understanding the quicker effect of the medication for newly symptomatic Parkies because they would benefit from low plasma content while my response to the first dose of the day is dependent upon the concentration in the blood rising to my much higher "threshold" level. I used to get medication nausea indications ten minutes after taking the 25/100; I now get these sometimes after 45 minutes following taking half a 25/250 tablet. The time was similar when I took whole 25/250 tablets three times a day instead of halves twice as often. I got no benefit from trying half a 50/200 CR Sinemet at bedtime. I attribute this to that medication never getting enough levodopa into my bloodstream to reach my current "threshold" requirement. I will state that CR tablets cost more and have benefit for some but not all of us. They are less efficient in most higher threshold Parkies, but can be used when spikes need to be minimized as Bob Naylor has evolved in medicating his wife. More learning and evolving this aspect of treatment algorithm optimization is needed. The data might correlate <average length of time for meds. to kick in> versus <years since first symptoms> with skewing due to older bodies typically decaying faster once PD starts. ron 1936, dz PD 1984 Ronald F. Vetter <[log in to unmask]> http://www1.ridgecrest.ca.us/~rfvetter/