To All
My apologies for the length
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NOTE:
In the recent thread on the topic of large amounts of Sinemet I have seen
some references to carbidopa. The carbidopa is a necessary component of
sinemet. It ensures that the levodopa gets to the brain and does not
cause trouble in other organs.
About 60mg of carbidopa a day is all that is required for this task.
However some of us take a lot of sinemet and thus a lot of carbidopa.
Alan Bonander thought that more than 200mg of carbidopa could be toxic to
some PWP and a daily intake of four CR 50/200 is not that unusual.
Fortunately sinemet comes in two different ratios of carbidopa to levodopa,
1 to 4, as in the CR 50/200 and the regular 25/100. The other ratio is 1
to 10 in the10/100 mix. This makes it possible to adjust the intake of
carbidopa as I did in the 'TEST' which follows.
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"TEST-----Reduce Daily Carbidopa Intake and See What Happens"
Anne Rutherford
September 1995
I would like to add my two cents worth to Alan Bonander's comments on
carbidopa. From my personal experience I think an excessive amount of
carbidopa could have negative effects. (over 200mg per day is too much)
In August/September 1995, with the approval of my medical advisers, I
tested Alan's theory in a planned reduction of my daily quantity of
carbidopa.
Why did I do this?
I had experienced very little improvement after a recent increase in
Sinemet. I began to have erratic switches from 'on' to 'off' and I was
having difficulty coping with this and with the severe mood swings that
also developed.
While this was happening Alan Bonander commented to the list that
carbidopa might cause trouble at doses over 200mg and my recent increase
in Sinemet had taken me over that threshold.
The Test
Fortunately Sinemet comes in two different carbidopa/levodopa ratios; 1
to 10 and 1 to 4. Thus it was not difficult to substitute a low ratio
Sinemet 100/10 for the half Sinemet Controlled Release 200/50 that I had
been taking. I kept to a preset timetable for the changes which gave time
for each alteration to stabilize.
Results
I found that there was very little change at first but quite suddenly
when the daily amount of Carbidopa approached 200mg I thought I felt more
in control. I still went 'off' especially at end of dose but these could
be dealt with.
I was very suspicious, thinking that my hopes had influenced my findings
but others confirmed that there were fewer unexpected 'offs', and I was
more even tempered.
I continue to take enough low ratio Sinemet to keep my total carbidopa
well under 200mg and I have not experienced the general misery and 'on'
'off' that spoiled my summer.
Some comments
*I cannnot eliminate the possibility that the improvement was due to
wishful thinking.
*It is quite possible that I reacted to the increased bioavailability of
levodopa in the tablets I substituted for the Sinemet CR. However after I
finsihed I cut back slightly on the daily total of levodopa with no
problems.
*Those who think that the Sinemet CR may be the cause of the problems
could organize another test by switching from a half 200/50CR to the
regular format 100/25 Sinemet.
Anne Rutherford <[log in to unmask]>
Newfoundland
