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On Sun 13 Oct, Charles Countryman wrote: > Recent listings have clearly stated the benefits of early use of > Sinemet. However I believe that it is incorrect to characterize Amantadine > as ineffective or old fashioned, especially if combined with Eldepryl. My > personal experience with these medications has been good. > > This 3rd year of medications, I've started to have the > usual Parkinson's problems again. Parlodel was added. But it may be time > to switch to Sinemet. However, I submit that Amantadine can work > effectively and isn't old fashioned. By the way, my Neurologist is a young > man. At 45, I feel old when talking to him! > ================================================== Hello Charles, I suppose I should have learned by now not to stick my neck out by making sweeping statements about PWPs !! Not having any personal experience of Amantadine, I 'went by the book'. My most trusted reference book (see below) Which is very modern (First pub. 1995) Doesn't even mention Amantadine. I extracted the following from an earlier but reliable ref. : - An anti-viral agent, accidentally found to have anti - Parkinson properties. - A safe drug (!! -see below) - useful in the treatment of mild cases. - About as effective as the anticholinergics (But its action is different) - Initial response within 2 weeks, then a gradual decline of benefit so that in many cases the improvement has been lost within 3 to 6 months. In the slowly progressive case however, the effect may be maintained longer. - Younger patients tolerate Amantadine well - 200 to 300 mg/day is optimal - No point in larger doses. - Side effects include confusion, hallucinations (esp. in the elderly) and a mottled rash on the lower limbs. - Swelling of lower limbs may be exacerbated by use of Amantadine. My conclusion from the above is that a) Your PD is (like mine) probably of the slowly progressing type. (Which is good news if you look at it in the right way) b) Amantadine STILL sounds like a mildly effective drug suitable for early cases of PD, with potentially worse side-effects than levodopa, and whose job could be done as effectively with a low dose of levodopa. c) Watch out for Parlodel -I do have personal experience of that and it is BAD. I have only ever encountered one person (He is on this list) who has a good word for Parlodel, and I have had many bad reports When you do go on to Sinemet, do try to keep the size of each tablet down as much as possible. Don't get stuck with for instance 3 x 250mg tablets per day. That is totally unnecessary.Much better to start with half a sinemet plus, taken evey 4 hours, and if that does not work, shorten the time interval down to a minimun of every 2 hours. Then go to a higher dose (three-quarters of a tab if you can do it - 1 tablet if you can't) and repeat the 4 hours coming down to 2 hours, and somewhere in there you will find what is best for you. If you have any questions feel free to ask. I can recommend this book as an excellent work. It is designed as a reference work rather than something which you read from cover to cover Parkinson's at your Fingertips by Oxtoby and Williams Class Publishing 7, Melrose Terrace London W6 7RL ISBN 1 872362 47 8 -- Brian Collins <[log in to unmask]