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Sat, 6 Jun 1998 01:17:34 -0400 Bruce Anderson <[log in to unmask]> wrote: >Hans, >This is positive, proven incontrovertible fact? I've never heard it >expressed so positively - and clearly - before. We should, if we can, stay >away from most Sinemet for the first 10-15 years. I was diagnosed in early >1995 and they have me on 4 25/100's a day of it plus 6 mg of Mirapex - and >i'm been doing very poorly, especially in the mobility department. It >sounds like i should at least cut back some and see what happens ??? Hi Bruce, There are no proven incontrovertible facts in PD, nor in it's meds. That's IMHO one of the mayor reasons for the diversity in treatments given. NO ONE knows what's best. Also it's strongly patient-related: the med that works excellent with one PWP, works not or poorly with an other PWP. Often it's a (long) period of try and error with various med(combinations) before the "right" combination is found. Meanwhile the PWP symptoms worsen or extra symptoms appear, and the whole procedure of try and error starts all over again. Some PWP indicate to WANT to start with L-dopa, because they want the best results NOW, while they are young and want to enjoy life NOW. In 10-15 years can change a lot (better meds, perhaps even the CURE). But as far as I know the general protocol used to give medtreatment to PWP by the top-neuro's in the Netherlands is the one I discribed for the reasons given. Of course this has to be adjusted to the PWP's needs and possibilities and reactions to the treatment started. Reading the above you understand that it's difficult to give a personal advise about the dose of your meds. That is a task of try and error for you AND your neuro! (BTW Mirapex (pramipexole) is NOT yet approved in the Netherlands, probably will be end of 1998.) Hope your mobility will improve soon, Greetings, Hans.