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On Fri 14 Mar, Donovan White wrote: > I just returned from a consultation for my mother (Joyce, 67 year, > diagnosed 5 weeks ago) at Mt. Sinai in NY. I have written about her > symptoms here (slowness, cannot use left hand, left arm weakness, slow > speech, off balance) before and the fact that her current dosage of Sinemet > (1-1/2 tablets of 25/100 3x/day) has had no effect on symptoms. > > She was diagnosed with Parkinson's today, and is in the early stages. It is > still possible that she has some other Parkinsonian disease, but the > doctor's belief is that it's Parkinson's (turns out she has rigidity and > slight tremor, too). The doctor changed her Sinemet schedule to 1 tablet > 25/100 4x/day and is having her add Permax gradually over the next month. > > Has anyone ever NOT had a benefit from Sinemet and then by adding Permax > gotten a good effect?? > > Also, is confusion a part of Parkinson's? I don't know how much confusion > on her part was just a function of having to go through a tough sort of > visit for anyone. > > Thanks for your help, advice, knowledge. (I'm beginning to wonder how I get > all my other questions in life answered; there's nothing like this list.) > > Debbie White > Hello Debbie, I must say that I have not encountered any PWP who has not responded to Sinemet and then HAS responded to Permax, and I have spoken to quite a number of PWPs. (There is nothing like a bold statement like that to bring people flooding in to dispute my words. On the other hand, no response will mean that you have your answer, so we'll see what happens. Would you just set my mind at rest on one thing: When you write 1-1/2 tablets do you mean 'One half' or 'One and a half' ? (I think I know the answer, but I just want to be sure.) I sense that you are not exactly impressed with the neuro's prescription of one 25/100 4 times a day, and although it does represent a more sensible time spacing of the tablets, you mother was getting a greater level of levodopa ( At the peak of the time history), when she took one and a half 25/100 Sinemet. If I recall correctly, I wrote before that if your mother shows no reaction to a peak of 200 mg Sinemet (i.e. two Sinemet 25/100 ), that would strongly indicate that it is not simple PD as we know it. I would not expect the Permax to change the situation. Permax is useful, but it is not as powerful as sinemet. I guess you should try the new regime, and if you feel it is ineffective after 2 or 3 weeks, go back and argue for more. Regards, -- Brian Collins <[log in to unmask]>