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FOR: Ida and Bev. Subject: Diphasic Dyskinesia Hello everyone. There is an old comedy routine where a man goes to see his Doctor and says: " Doctor, when I hold my arm up like this, I get a terrible pain in my shoulder - what should I do ?" and the doctor says "Stop holding your arm up like that". I know, its corny but it appeals to my sense of humour, AND - It carries a message for us. I still don't know for sure how many people are taking their meds in such a way that they drive them selves into the Overdrive Region (or the Twilight Zone as I like to think of it), because everyone has gone very coy about quoting tablets taken and the times at which they are taken. The point is, If the overdrive route is taken, there is a guaranteed band of dyskinesia waiting as you descend to the lower levels again, and as far as I am aware, it is heavy dyskinesia as well. I do not know if this mechanism is the one which Ida describes, because until I see the track of how she gets to the dyskinesia zone, it is impossible to know. Judging from the stream of learned papers which have been quoted during this discussion, a lot of good men have tried and failed to explain what is happening to cause this problem, so a simple Engineer has no chance - and it is true - I can't follow the detailed chemical reactions that are going on in there, but I can stand back and make a few observations : My philosophy in taking levodopa is to take just as much as is needed to restore the dopamine levels in the brain to what they were before the symptoms of PD occurred. I do NOT agree with stuffing a large quantity of levodopa into the brain in the morning, and keeping it there all day, because that is a configuration which does not occur in a normal person. I have a model in mind where the dopamine flows in nicely regulated quantities, reaching the places that it was supposed to reach, and not getting into other areas. As soon as the dopamine level exceeds that well- regulated level, I imagine it spilling out from its proper channels and starting to overrun neurons and synapses which were not supposed to be zapped at that time, and thus initiating movements which were not intended (i.e. Dysknesias. It also explains why each person has his own little collection of dyskinesic movements: The dopamine will have a pretty well- worn track to follow since it is overflowing on a regular basis, so we might expect the same symptoms each day. This brings me back to the corny joke- The best way to avoid these winding down dyskinesias is not to go up there in the first place. I have been doing it for 17 years, and the system still works fine. - The only problem is the chaos caused by those dratted meals - I'll have to stop eating: It's the only logical thing to do !! -- Brian Collins <[log in to unmask]>