On Sun 15 Feb, Phil Tompkins wrote:
> Marling McReynolds wrote:
>
> > I have noticed that although most of us seem to be trying to get
> > by on the least amount of meds, the doctors seems to prescribe
> > larger than needed doses for first time users, especially of
> > sinemet. Is this my imagination?? I was on 50/200 every 4 hours
> > in the beginning . . . .
>
>
>
> If you didn't know much about PD, how would you apply these
> instructions in the case of someone who had just been diagnosed?
>
> Phil Tompkins
> Hoboken NJ
> 60/9
>
>
>
Hello Phil. You may not have followed my recent posts on the subject of
Sinemet taken in the early days od PD. In thos pasts I try to explain how
and why in our early years with PD we are able to tolerate very large doses
of Sinemet - when we only need a little, and conversely why after 6 or 7
years with PD, we begin to find that just when we would like to increase
the doses, we can't because we run into dyskinesias.
The rule is: A little and often, even during those first 6 or 7 'honeymoon
years. The crude chart below illustrates the different philosophies. The
trouble is, I cannot promise any reward for economising in those early
years - It just seems right!
________________________________________________________________________
|_ Sinemet |
|q |
| q q - mg/day that the brain can tolerate |
| q |
| b - mg/day that the brain needs to avoid tremor|
| q |
| |
| q |
| |
| q |
| |
| q |
| q |
| q b |
| q b |
| bq |
| b q |
| b q|
| b |
| b |
| b |
|____b________________________l___________________________l_____________|
5 10
years after diagnosis
Notes: Don't read too much into this crude graph, but it does show the
differenc between what we need (the bottom line bbb , and what we
usually get (the top line.
Note also that as drawn, beyond about 9 years, we need more than we can
tolerate, due to the onset of dyskinesias. This is where the dopamine
agonists start to help.
Regards,
--
Brian Collins <[log in to unmask]>
