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With reference to the posts from Wesley Balk, amd Bob&Joy Graham,

I have mixed views about the book by Dwight C McGoon. The first 70
pages are by far the most readable and understandable descriptions of how
the brain operates (In the areas relevant to PD) that I have read. After
that he goes into his drug holiday mode, and I stop reading. To put it
delicately, I think it is rubbish.
   It appears to me that people who say that they do benefit are those who
are taking what I regard as an overdose of levodopa. It is possible for
some PWPs to take an overdose first thing in the morning (They often talk
about the 'tablets cutting in' as they go zooming through the ideal dose
on the way to the overdose).  By the occasional tablet administered at the
right time, it is possible to stay in this overdosed state most of the day.
However, 'What goes up must eventually come down', and this is where the
trouble starts: the dyskinesias have to be faced, and seem to occur as the
PWP comes back down through the various levels to essentially an un-dosed
condition.
  The stresses involved in this nightly wind-down must be considerable,
and the concept of a drugs holiday more attractive. Also, having purged
this possible overdosed condition, the rigours of an advanced Parkinsons
condition with no medication is to me totally unacceptable. About three
months ago, I sufferred a 'shut-down' of my digestive systemsuch that for
two days I could get no result from the tablets, because they were not
reaching the lower intestine, and hence not getting into the bloodstream.
There is no way that I woould voluntarily decide to go through those days
again.

Joy Graham writes :
"There are many theories about putting PD medications into the system.
school believes that a constant supply of levodopa such as you get in the
slow release (Sinemet CR or Madopar HBS) is more beneficial in the long
run than the stops and starts of regular dosing. Many neurologists won't
use the CR because you actually need MORE of it to get the same response"

Joy, I would say that Every neurologist acknowledges the desirabilty of a
constant, steady supply of dopamine to the brain  systems. Where people go
off the rails is in thinking that that means the CR tablets should work OK.
The point is that the rate of release of a CR tablet is just one rate of
release in a broad spectrum of release rates. What we really want is a
range of tablets, each containing a different release-rate so that we can
'mix and match' to get the right rate for us (Remembering that in 6
months time the percieved required rate will have changed.

Regards,
--  Brian Collins  <[log in to unmask]>