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Brian Collins wrote: > > This is a subject which irritates me from time to time, because to me > it indicates a lack of understanding on the part of some doctors of > what they are doing: > > The most important drug which we take is undoubtedly levodopa: All the > others are really accessories to the levodopa, so it merits a > treatment om its own. > > Sinemet and Madopar come packaged in tablets or capsules, in units of > 50, 100, and 250 mg (or 100 and 200mg Controlled release). > > Unfortunately, people do not come conveniently calibrated in similar > values. Everyone happily acknowleges that PWPs are all different, and > this certainly applies to the amount of levodopa required, so why do > so many doctors insist on using 'one tablet here, one there, and if > that doesn't work try doubling the dose.' The reason why they get away > with it is that in the earlier stages of the disease the remaining > dopamine-producing cells compensate for any over or underdose, but > when you get to the sharp end, when there are effectively no remaining > dopamine-producing cells left, the match must be exact. I have found, > for example that my requirement is for 37 mg per hour, and the range > that I can accept is no more than plus or minus 1/4 of a madopar > dispersible (or +/- 12 mg). I achieve this by taking 1 and 1/2 > Madopar dispersibles every two hours. (This is because a madopar lasts > for 2 hours.) > > It may sound too much trouble, but this philosophy has kept me going > through 18 years of levodopa, (and I haven't finished yet.) > > The plain fact is that no-one is going to go to such trouble on your > account. Everyone is different, and it is up to each of us who wants > to extract the best from the drugs, to undertake a modest amount of > experimentation (If you are lucky, you may find a doctor who is > prepared to help) > > I know that many people prefer to leave it all to their doctor or > specialist, but I have doubts whether anyone who is not directly > experiencing the effects can define requirements such as these. Does > anyone else work to close tolerances like this? > > Regards, > -- > Brian Collins <[log in to unmask]>