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On Mon 28 Jul, Dave Garboczi wrote: > Dear all, my father (75 / 7 yr diag) tells me he does not feel a > kicking-in after he takes a Sinimet. He says he doesn't feel anything. > Is this within the normal range of responses to Sinimet? Are there > patients for which Sinimet doesn't work? His is not very advanced-- > drives car, mows lawn, walks a 1/2 mile in the morning. > Thanks, > Dave > > I assume that 'Drug Kick-in' is that welcome point at which you can feel the PD symptoms (Stiffness, tremor, etc) melting away in response to the Sinemet. It is not clear from your post whether your father used to feel the drug kicking-in, but no longer does, or whether he has never felt the drug kick-in effect. I will assume that he has never felt the kick-in, because it seems a bit more likely than the alternative. Possible reasons for this include: 1/ Your father may not taking enough Sinemet to reach the 'Kick-in' point. This is quite possible: The flow-rate of Dopamine required by the brain is relatively small, but the levodopa contained in the tablets which we take is under continual attack as it travels through the Digestive and blood transport systems. Only when the flow rate of the Sinemet exceeds the required amount to make up for the losses due to PD will the 'Kick-in' effect become apparent. At this point, the PWP is said to be 'ON' . The remedy is fairly obvious : Take some more Sinemet (Not too much more), and see what happens. If you decide to try this, it would be wise to consult your Doctor or Specialist before you start. 2/ The other possibility which you must consider is that your father may not have Parkinson's Disease at all. There are a few diseases which can cause Parkinson- like symptoms, but may not be Parkinsons Disease. One possibility is Alzheimer's, which can easily (in the early stages) be miss-diagnosed as PD. Only very expensive scanners can identify PD in a living patient, but a good rule of thumb is wether he reacts to Levodopa (Which gets turned into Dopamine in the brain.) Failure to respond to Sinemet is again a possibility which should be considered in conjunction with other indications. I hope this helps, Regards, -- Brian Collins <[log in to unmask]>