From: Brian Collins <[log in to unmask]>
Subject: Sinemet CR
To: Multiple recipients of list PARKINSN
Hi Alan,
The source of my comment on avoiding breaking the Sinemet CR
tablet was a local consultant neurologist for whom I have
considerable respect (and there are not many of them !). I think you
make my point for me when you say that two halves yield more benefit
than one whole. By more benefit I expect that you mean a higher
release rate of levodopa, and it was just this effect which I was
suggesting may have contributed to the nausea experienced by
Patricia.
I treat the Sinemet CR tablet with considerable respect - in fact
I cannot take it any more because its release rate exceeds my
tolerance level, giving me unacceptable dyskinesias. I agree with
you that every person has a different experience, probably because
our digestive systems vary so much. In my own case, (two years ago
when I could tolerate it) the effective duration of a Sinemet CR
was five hours total, but to avoid the dip between tablets I had to
take them at 4-hourly intervals. A friend of mine takes a total of
3000 mg of Sinemet per day, which would blow my socks off if I took
it !
It has been my experience that there is an 'optimum' dosage rate
for most people, which will give the best relief of PD symptoms.
As time goes by, there comes a time when that required doseage
causes more discomfort due to dyskinesia than benefit. At that point
we must look elsewhere for help. I have managed to spin it out to
13 years on Levodopa, and still going but then, as I said before,
we're all different.
I am sure that the aim of all this juggling with tablets is to get
as near as possible to a constant rate of levodopa flow into the
bloodstream, and hence into the brain. To achieve this without
CR-type tablets, I use Madopar dispersible (12.5/50) tablets, simply
because I can break them easily into halves and even quarters to get
the precise doseage I need ( Currently I take one and a half tablets
every two hours.)
I would like to carry on this dialogue, but perhaps on a 1-to-1
basis ? I may be boring most of you by now!
Regards, Brian Collins
