Diana,
I think that Brian is right; if so, the dyskinesia of your mum is of a kind
that is most frequently seen, caused by too high a level of dopa. It is easy to
know whether this is true. One just has to know the time the dyskinesia
appears. Is it during the time the dopa is on its highest level, between a half
and a whole hour after taking the last sinemet, than your mum suffers from peak
of dose dyskinesia. If however it comes between two and three hours after the
last sinemet, it is wearing off dyskinesia. If it seems not that clear to you,
it is the most sensible to assume your mother suffers from the peak of dose
dyskinesia.
Ida Kamphuis
n 5-7-97 23:59, in bericht <[log in to unmask]>,
Brian Collins <[log in to unmask]> schreef:
> On Sat 05 Jul, Diane Lucas wrote:
> > Dear Brian
> >
> > My mum has taken Sinnemet for nearly 2 years.
> >
> > She takes 5 125mg per day
> >
> > At 10am when she has her breakfast
> >
> > 12.30pm with her lunch
> >
> > 3.00pm with a biscuit
> >
> > 5.30pm with dinner
> >
> > 8.00pm with a biscuit
> >
> > Is this info enough
> >
> > Thanks a lot
> >
> > Diane
> >
> >
> Hello Diane, I think I can explain what is wrong about your mum's tablet
> schedule: Has anybody given your mum advice about when to take her tablets,
> relative to meals? I suspect that someone has, probably when you were
> introduced to Sinemet. In a small number of people, some nausea is encountered
> when patients begin taking Sinemet, and they are advised to take the tablets
> with meals, because that reduces the nausea. Well, it certainly does that,
> but it accomplishes it by a reaction with the protein; the protein in the
> food breaking down the levodopa, so that you get less nausea because you get
> less Sinemet!!
>
> The schedule which you sent indicates that only the 3:00pm and 8:00pm tablets
> are taken without meals, from which I conclude that your mum's basic levodopa
> requirement is actually less than that delivwred by a Sinemet Plus (Known to
> our friends in the USA as Sinemet25/100). This fact is masked most of the
> time by the meals, but this is a very imprecise way to do it, because of the
> problem of knowing how much Protein is in the meal. The easiest way of
> avoiding this interaction is by taking your tablet some 20 to 30 mins BEFORE
> your meals.
> This should give you the full effect of the tablets, BUT, we know that that is
> too much, so the problem is how to find the new optimum levodopa flow rate.
> This is where I offer to use a computer program of mine to help find this
> target levodopa flow rate. If you want to have a go at it, take a look at
> Simon Coles' Web site: The URL is as follows
>
> http://james.parkinsons.org.co.uk
>
> Look for my name at the bottom of the home page and click on that. You should
> find a couple of notes describing the way to generate data for the program.
> If you want to ask questions, please do so, otherwise call me when you feel
> that you are ready to go.
>
> By the way, where do you live in the uk?
>
> Regards,
> --
> Brian Collins <[log in to unmask]>
>
