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On Mon 18 Aug, Stephan Schwartz wrote: > Greetings Phil: > You wrote - > For Phil Gesotti <[log in to unmask]> 08/15/97 > > what is meant by peak dose dystonia. What are the > symptoms?<<< >>>My new neuro added Permax to my > current 4 daily Sinemet 25/100 CR. As I titrated (love that > word) from 0.05 to 0.75 mg per day over a two week period, I > noticed a decrease in the dystonia; however, after about a > three week period the dystonia would return at times during > the day.<<< > >>>I was having problems with dystonia last week so I > decided to go cold turkey on Monday and try no meds. I felt > great all day. I took two 0.25 mg doses of Permax on > Tuesday. I felt O.K., but was somewhat agitated in the > evening. For the rest of the week I took a morning and early > evening dose of 25/100 Sinemet and a morning and noon > time 0.25 mg dose of Permax. I seem to feel better, but am > not sure that I may also be experiencing the benefits of a > mini-drug holiday. Is dystonia also a symptom of over > medication?<<< Phil; I have just returned from vacation,so if my comments have already been answered, or I have mis-understood the questions I apologise. I noticed, reading your messeage above that there was no mention of backing-off on the Sinemet. As I understand the process, the claimed effect of Permax is that it does some of the work of the Sinemet, but without an increase in the excitation of the side-effects which can provoke dyskinesias or dystonia. So, if you just add some Permax to your diet, you end up somewhat over-medicated, and with about the same levels of dyskinesias and dystonia. Over-medicated is as bad as under-medicated in my book, so what I did in my case was (having increased my Permax intake) to back-off the sinemet dosage until I was effectively back where I started on medication level, but also had the increased dyskinesia margin resultng from reduced Sinemet intake. I don't see mention of backing-off Sinemet in your comments, which I believe is necessary to get the best out of the Permax. We are talking small numbers here, so don't start dropping whole tablets out of your schedule. I used my program to analyse the effects - without it, I don't know how the neuros arrive at an answer, but it must be very hit-or-miss. Regards, -- Brian Collins <[log in to unmask]>