 |
 |
For Phil Gesotti. Hello Phil, on reading your reply, a number of points struck me which you might find to be useful: 1/ The action of Permax is very slow. According to ny neuro, and I agree with him, Permax taken over a period tends to form a 'raised platform' from which the levodopa then does its short time-period thing. Looking for the effect of a single dose of Permax in the hours following the dose is doomed to failure - it's effect is so sluggish. Over the past few years I have gradually raised the amount of Permax to offset my steady deterioration so that I am currently taking 2.5 mg of Permax. I have had no side effects, and the effect seems to be linear over the range 0 to 2.5 mg. 2/ I find the suggestion of your neuro to cut back on the night time Sinemet (as a means of reducing the intake) to be very strange, but I guess that she was really not keen to reduce anything. I have found that a single controlled release tablet (25/100) taken immediately before going to sleep gives me at least 4 hours of continuous sleep. (This corresponds to about a half to two thirds of my daytime dosage.) 3/ If you want to reduce your daily intake, then assuming that (like me) you have arrived at a sequence of tablets where each dose takes over from the previous one, maintaining a constant level of medication, it makes no sense at all to make a giant hole in the schedule by deleting a tablet. Similarly, spacing out the tablets differently will just either leave a gap, or if you reduce the time, create a local bulge. The only thing that makes sense to me is to shave bits off your common levadopa tablet (e.g. a Sinemet 25/100, or in my case, a Madopar 12.5/50) so that each dose is a bit less. I am not aware of ever hearing a neuro talking about breaking down the size of a tablet, but why should our symptoms neatly match the available sizes of tablet? Does anyone else break tablets into halves and even quarters as I do? Regards, -- Brian Collins <[log in to unmask]>