Michel,
Your description of the what madopar does to you is not the same it does to
any other PWP's. However your reactions on the dopamine might be the same
as is on different ways described below. If that is true you belong to a
minority among the PWP's who suffer from wearing off symptoms, who have the
so called DID reaction on dopamine. You say after a time of doing its work
fine, you get the feeling it's influence is disturbing. You did not write
exactly how it disturbs you.The fenomenon of DID and wearing of med's
dyskinesia are recently ample discussed and it is clear that the fenomenon
gets not much attention. I have gathered some relevant passages from recent
postings about this matter. I hope that by reading them your confusion
about what is happening will be dimished.
Ida Kamphuis 52\12
Holland
By David Langridge:
There is however a fly in the ointment because the effecftiveness of each
dose of sinemet is curtailed because mainly at the end of a dose when it's
effect is beginning to wear off I experience an unpleasant drug induced
state akin to dyskinesia but not in it's wild form- I can best describe it
as a sort of mainly internal writhing with incipient neck movements and
body swaying all reasonably controllable although an outside observer might
guess that I was having a bad go of indigestion!Also more often than not
my left leg goes rigid and I find it harder to walk than if I had not taken
Sinemet.So here is a drug induced problem which seems to more or less
fit the term diphasic dyskinesia which I first came upon in the 'Algorithm
for Parkinsons'
By Rosemary Paul:
After being diagnosed with PD about 8 years ago this symptom
started for me a year ago - and at times drives me batty (g). I had
always thought dyskinesia happened when there was too much dopamine
was released in your brain but this definitely happens at the end of
dose time.My muscles get rigid from trying to stop moving and I ache all
over.This dykinesia does not seem to noticed by others but I feel I am
going to squirm out of my chair.
>From the archives:
Choreodystonic dyskinesias are also seen in a second distinct pattern,
in which these adventitious movements occur just at the beginning and
again at the end of the levodopa response cycle. This has beentermed
"diphasic dyskinesia" or D-I-D response, a shorthand for"dyskinesia-impro-
vement-dyskinesia").[124] This pattern is much less common than peak-dose
dyskinesia and is often difficult to diagnose because the pattern may not
he obvious, either to the patient or the clinician, The end-of-dose period
of dyskinesias is typically more prolonged and troublesome than the initial
dyskinetic period of the levodopa cycle.
>From myself:
The confusing thing was that I felt fine when the med's were high and bad
when they were low. It seemed to make sense to take more. I did and the
results were more end of the meds dyskinesia and losing part of my "good
times". My neuro said I should not take more but less leva dopa. The
impulses to move were caused by l-dopa and were always worse with higher
intake. I could hardly believe him, but had to try anyhow. I had no
alternative. So I gave it the benefit of the doubt. And the result showed
my neuro was right. So the symptoms were caused by a too high dosis but
were manifest after the dosis had diminished. A sort of abstinence phenome-
non. On my next visit my neuro said the exact causes was unknown, but it
indeed seemed to be the same phenomenon that addicts suffer from (cold
turkey) and that unfortunately it is not easy to treat.
