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On Fri 13 Feb, Rick Hermann wrote: > Hi List, > > I've received a lot of feedback from listmembers about starting out > treatment (46/2 months) with Sinemet (CR 50/200 once a day). My > neuruologist explained it as: let's see if you respond to anti-Parkinson > meds, and a trial course of Sinemet (1 month) is the quickest test route. > If you do, we'll get you off the Sinemet and onto other meds more > appropriate for your age and level of disease. > > My question, in response to cautionary advice, is: will one month's worth > of Sinemet have significant negative effects? Should I go back to the neuro > asap and say Hey! Let's go another route NOW. The neuro-suggested course--a > 1-month test--makes sense to me, but I am listening to advice from this > wonderful group with wide-open ears and a commitment to my own well-being. > > Meanwhile, thanks for the info on finding a MDS. I have good leads in the > Seattle area. > > Best, > > Rick > Bellingham, WA > where the crocuses are up > > > Hello Rick , I realise that I didn't really answer your direct question in my previous answer so let's see if I can do it this time. Sinemet has no 'build-up' characteristic: You will know on the first day if you do have a positive reaction to it, so a month just to see if you react seems excessive. I have another, more subtle objection , concerning the use of large doses of Sinemet to newly-diagnosed PWPs. Yes, your brain can apparently handle the overdose without distress, and No, I have no proof that repeated doses of these large amounts cause any long term damage, but I still worry about it. One thing is sure: you don't need such large doses. I have already written about that as well, but a more straight-forward way of looking at it is as follows: If you think back to the time before the first symptoms started to show (Usually 2 to 3 years defore diagnosis - 6 years in my case ) It is obvious that up to and including that time, your required dose was zero. As you probably know, you are down to the last 20% of your Dopamine-producing cells when the symptoms show, but all that has actually happened is that you (at 2 months since diagnosis) have lost a few more cells , and all that you need is a small amount of Sinemet to counteract the effect. Unfortunately, none of the drug manufacturers make a CR tablet with a release rate of (say) 10 mg/hour, so to get the same effect you would have to take half of a tablet called Sinemet LS here in the UK - It has only 50 mg of levodopa in it., and the effective duration is about 2 hours, so you would get 25 mg every 2 hours at about a constant rate. I don't know of anyone who has taken my advice (!) and it does impose a burden taking a tablet every 2 hours. I have followed the philosophy myself since I realised the implications, but several years had gone by in which I took more than the minimum amount. I was diagnosed 19 years ago (Age 39) and for the last 18 yrs have taken Sinemet- for the last 10 yrs based on my 'minimum necessary' philosophy. Regards -- Brian Collins <[log in to unmask]>