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hi jeff and joan jeff wrote: >My wife (54/4) is taking a significant amount of medication >an increasingly more frequent intervals. >Every 1 3/4 hours (one and three quarters hours) >she takes 1 Sinemet 25/100, 2 Sinemet CR 25/100 >and 3/8 or 3/4 mg Mirapex. >Somewhat less often when she is sleeping. >Has anyone had experience with these levels of usage? i have to throw my two cents into the ring with ron vetter and barb mallut pd is known as a 'designer-disease' and as such, varies widely in symptoms and progression from individual to individual however, my initial impression is that joan has been prescribed a huge amount of dopamine replacement/dopamine agonist medication especially so for someone who was diagnosed only four years ago e.g. i was diagnosed in 1988 after witnessing the gradual onset and increase of slowness of movement and muscle rigidity [bradykinesia] i was examined by a neurologist who confirmed pd and started me on sinemet right away [since i was having so much difficulty walking and writing] i was instructed to titrate the sinemet dose up very slowly [over a period of three weeks] up to a dosage level of 25/250 sinemet[carbidopa/levodopa] x 2 and selegiline 5mg x 2 my neurologist told me then that pd progresses very slowly - i would have no surprises - i'd have time to make adjustments in my meds when necessary after nine years my selegiline dosage has remained constant and my sinemet dosage has slowly been increased to 700-800mg per day the greatest change in meds has been the frequency of the sinemet dosage timing in order to minimize the effects of developing 'on/off' periods as the levodopa level rises and falls e.g. i am now taking one-half sinemet 10/100 tab every 90 minutes, instead of one whole sinemet 10/100 tab every140 minutes this 'fine tuning' has enabled me to function essentially normally with minimal 'off times' [except, of course, for the known female hormone 'freeze' or non-response to levodopa twice per monthly cycle] assuming a fourteen hour active day it appears that joan has been prescribed a [minimum] daily total [excluding the mirapex] of: 1 Sinemet 25/100 x 8 = 200mg carbidopa; 800mg levodopa and 2 Sinemet CR 25/100 x 8 = 400mg carbidopa, 1600mg levodopa minus the effective loss of 25% of the CR tabs = 300mg carbidopa, 1200mg levodopa resulting in an effective daily total of = 500mg carbidopa, 2000mg levodopa from all i've learned about pd and all i've read on this listserve since october 1995 these medication levels are disturbingly high for such a newcomer to pd since mirapex has only been available in the usa [assuming you are american] since august 1997 i have to conclude that joan has been seen by a neurologist during the past year can you summarize her progression of symptoms and her medical advice during the past four years? unfortunately there still is a lot of misinformation out there even among the medical/neuro community about current pd medications we all have to become our own best advocates when it comes to symptom/meds management your cyber-sibling janet janet paterson 50-9 / sinemet-selegiline-prozac almonte-ontario-canada / [log in to unmask]