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On Sun 09 Mar, Joao Paulo Carvalho wrote: > Charles Countryman wrote: > >es, > > Against facts there is no arguments...There are old hands in this list > that take Sinemet for a long time and found it was the better choice > since then as for ex. Brian and others.If I were you I would check with > at the least 3 other specialists and then judge. > Hello Joao Paulo, I must have missed your initial email , but I have seen the replies. I am, as you indicate, an advocate of early introduction of Sinemet/ Madopar, with one proviso: that the sinemet is used only to replace the missing natural dopamine, and not taken in large doses as I now understand some people use it. Using that philosophy (At least in more recent years as I learned more about it), I have managed to make effective use of Sinemet for 17 years. There is one point which I may have neglected to make before, concerning Dopamine agonists. Many years ago, when it was quite new, I was given Parlodel (Bromocriptine), and like a lot of people, after a few months I began to show paranoid tendencies, and went through a bad patch before I discovered the cause, and immediately stopped the tablets. I was back to normal in 2 weeks. However, apart from that, the Bromo. worked as advertised in that it replaced some Dopamine and allowed me to reduce my sinemet intake by a little bit. When Pergolide (Permax) became available, I went on to that, with no side-effects, and am still taking 2mg per day. The main reason why I take these agonists, (and note that I steer well clear of the recommended maximum dose- 3mg in the case of Permax) is difficult to explain, but it seems to me that the permax tends to 'soften' the transition from on to off, and off to on. When taking just Sinemet, as I did after the Bromo problem, there was a tendency to suffer muscle strains, and on occasion it almost felt as if part of a muscle was wanting to contract, and the rest was trying to relax, giving painful tearing sensations. The dopamine agonists seem to help to avoid this. I can see that, by advocating the early introduction of Sinemet, I may have appeared to be arguing against the use of agonists, although I am sure that I have not specifically said so. To set the record straight, I consider that for the long-term Sinemet user, the introduction of a modest dose of levodopa agonist can be beneficial in promoting smoother transitions between on and off. Sorry if I have misled anyone. Regards, -- Brian Collins <[log in to unmask]>