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I'm not sure, but I understand that dopamine is needed at numerous sites outside the basal ganglia, including the peripheral system- too much carbidopa in the usual sinemet formulation deprives them.. I think that is why they have Sinemet 10/100, for example, instead of 25/100. To repeat, this is just a guess. Cheers, Joe J. R. Bruman (818) 789-3694 3527 Cody Road Sherman Oaks CA 91403 On Thu, 17 Oct 1996, Camilla Flintermann wrote: > We've been trying to get a med routine that will help Peter with the > awful lethargy he experiences at many times through the day. About 6 weeks > ago the neuro put him on 6XSin>CR 50/200 at 4 hour intervals around the > clock--no improvement. Today I went armed with info from this list re: > CARBIDOPA, and when I suggested that 300mg x day was too much, he agreed, said > "that's what I might have said myself" (but of course he DIDn't say it first) > and agreed to move P. off the CRs and try 25/250mg Sinemet instead. He > suggested starting with 4 x day, but said we could go to 5 or 6 if needed, > and still be at 1/2 the carbidopa P. gets now. To my question about toxicity, > a point Alan Bonander made on the list, he shrugged, and said there's no > evidence of that, it's just that you don't*need*more than 70-100mg carbidopa. > This leads me to ask if anyone has evidence to cite about toxicity? Or is it > one of those "possible" things we so often encounter with PD? I'd appreciate > any leads you can give--we're gradually"educating"this neuro, Peter thinks-- > but he doesn't do email---yet! He listened better today than usual, perhaps > because he had a med student observing in the interview? > Camilla Flintermann, CG for Peter,78/7 Oxford,OH >