 |
 |
"Stan R. Houston" <[log in to unmask]> wrote in part: <<<I have the "Gait-Related" Parkinson's. Have nev snip began taking one 25/100 Sinemet pill three times a day with meals (about 6 hours apart). During the nearly six years that have passed, I have changed doctors and have increased the Sinemet dosage gradually so that I can remain functional most of the day. For the past eight months, my Sinemet dosage has been: two and one-half 25/100 tablets at breakfast and lunch and two 25/100 pills with dinner. That usually covers me from approximately 7:00 or 8:00 a.m. until about 10:00 p.m. Some days, late in the afternoon, I have a gap between when the lunch pills wear off and when I take my evening pills. Of course, there are those wonderfull days when the Sinemet takes four or five hours to kick in.>> the use of 2+1/2 25/100 carbi/levodopa tablets at breakfast and lunch is not as good as using one 25/250 tablet. because of the reduced carbidopa - and the lower cost. taking levodopa with meals is less effective than taking it with a relatively empty stomach and following the med with a small amount of orange juice or a prune or a few mouthfuls of cereal/bran, then a small amount of low protein (non meat) food about 20 minutes later. I recommend that you ask your doctor to have you try a more "level" dosing to reduce the peaks and raise the valleys in the amount of levodopa in your bloodstream. Using halves of 25/250 carbidopa/levodopa tablets - taking one half upon awakening; the second half at mid-morning; a third half 30 minutes before lunch; 4th at mid afternoon; 5th 30 minutes before evening meal; and a 6th mid-evening if you have 5 or more hours after the evening meal before retiring. <<<<About three weeks ago, I got out of bed one morning and discovered that my early-morning limp had suddenly turned into an early-morning quick step and falling problem (propulsion). I could barely walk. My doctor suggested I try taking one time-release Sinemet CR (50/200) at bedtime. So far, this has worked. The pill does not kick in until about 5 hours after I take it. When I get up at 5:00 a.m, it's still working, so I have the freedom of movement I need to shower, dress and get ready for work. Unfortunately, that brings my total 24-hour dosage of Sinemet up to 900 mg. That concerns me, but I don't know what else to do. So far, I have not developed any serious dyskenesia problems, although I realize that is a possibility. Anyone had any similar experiences? Anyone have any suggestions?>>> the 25/100 Sinemet CR will have nearly the same action-profile (peak levodopa at about 2 hours after taking and down to about 25% of peak level after about 5.5 hours), but is less medication - and may let you sleep better. More than 100 mg. per day of carbidopa may hinder peripheral neurotransmitters or cause other detrimental effects (Pat Martin message re biochemistry). <<<PROBLEMS: Main one is depression, which I believe is drug induced. Some days, late in the afternoon, I sink into a deep blue funk if my lunch pills wear off before dinner. A period of depression and paranoia follows for about an hour. When I feel an attack coming, I usually curl up in my recliner, turn snip allows me to sleep at least four or five hours. Of course, that means I''m awake at 3:00 a.m., playing with my computer, watching movies from the satellite dish, reading, or rearranging books, videos or furniture.>> I doubt that your depression is drug induced. as you note, late in the afternoon - pills wear off. THAT is the problem! You are under-medicated then - and that is a return to being parkinsonian - which is depressing. It is loss of functionality because the brain is not able to keep up with the body's need of neural message sending. The half as much twice as often advice solves this problem. <<FOR BRIAN COLLINS: I am very interested in seeing the "user guide" for taking medications in the optimum configuration. Unfortunatately, I cannot get into your files using the URL address you gave on October 27. Can you communicate it some other way? Or tell me the secret for getting into the address through the Internet? Thanks.>>> I am helping Brian help any of you by having the "sub-pages" that describe the program and data that the subject who wishes to have Brian do his analysis must prepare and send to Brian. Does your statement that you cannot get into the URL mean that you have no web browser available to you? Or, does the statement mean that your attempt using a browser did not work in opening the URL? Some discussion and charts that I prepared to provide access to all to show Bob Naylor's data and graphical addition of medication from multiple doses during the day are pertinent - these may be found as the last sub-page you can go to from the Parkinson paragraph which is the first thing on my home page. The URL is the last line of my "signature". -- ron 1936, dz PD 1984 Ridgecrest, California Ronald F. Vetter <[log in to unmask]> http://www.ridgecrest.ca.us/~rfvetter