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Help on a related subject, please! I have asked 3 neuros this question but never got an understandable answer. Is there a defined amount of Sinemet available to each of us PWPs in a lifetime---unkinown in amount but definitely limited. What I mean by that is: if we take more now, will the dyskinesia begin earlier and therefore there will be less available for later? Are we using up our "allotment" by taking Sinemet soon after the diagnosis or is there another reason to delay starting Sinemet? I have asked this same question in a lot of different ways because I seem to have trouble making myself clear on this subject--but I think this group can help me. Many thanks Nancy Shlaes (61/4) Brian Collins wrote: > On Mon 20 Apr, Janet313 wrote: > > hi siblings > > > > i need some advice > > or maybe just some 'i've been there and done that' contact > > > > > i'm intrigued by the tolcapone possibilities; > > however, i would like to get this current sinemet question sorted out > > before i start mixing any other new ingredients > > into my brain's chemical cocktail > > > > any ideas/experience out there > > with 'generic sinemet' vs 'brand name sinemet'? > > > > janet > > > > janet paterson > > 51/10 - sinemet/selegiline/prozac > > almonte/ontario/canada - [log in to unmask] > > > > > > > Hello Janet, I didn't answer your initial call for help, as I was > working on my Living with Levodopa paper, and I expected that > someone else would cover anything I might say. However they didn't > and so I am putting in my comments rather late. > > The only thing that I can come up with on the Generic drug issue > is that a long time ago, I remember someone quoting the > specifications controlling the levodopa content in generic > Sinemet, and the number was amazing (I don't trust my memory > enough to be dogmatic about it, but I think the tolerance was > + or - 20% !!) This alone could be the cause of your problem. > > On the more general subject of your meds, I have a suggestion > which is simple for you to try, and has been tried and tested > (by Me !) . At 12 years with PD ( 9 years ago), I was in a > very similar position to you, and had evolved almost the same > strategy to meet it: You take 1/2 a Sinemet10/100 every 90 mins > (= 33 mg/hour) and I used to take 1 and 1/2 Madopar 12.5/50 > every 2 hours (= 37.5 mg/hr). So where do we go from here? > What I did, and what I would recommend to you, is to introduce > a Dopamine agonist. The only available one 9 yrs ago was > Pergolide (or Permax) so I used it. It was fine for me, and I > have continued along the same lines: I still take 1 & 1/2 mg of > Levodopa 12.5/50 every 2 hours, but as PD progresses, I have > increased my dosage of Permax - currently at 3.5 mg per day. > As the time has gone by, this strategy has provided me with a > near-constant outward appearance, and I would recommend it to > anyone as the best method of spinning out the meds to make them > last as long as possible. > I hope you feel able to try this method. (Any of the current > agonists should do, because in this context, I believe that > they are all very similar). It is the potential for side-effects > which cannot be predicted that makes one agonist different to > another. > Regards, > -- > Brian Collins <[log in to unmask]>