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On Mon 27 Jul, William Heitman wrote: > Sinemet has both an acute and chronic effect. > > The acute effect: > > Each pill gives the PWP what we recognize as "On" and "Off" several times a > day in some cases. However, there is also a chronic effect to the drug. > > > The chronic effect: > As one increases or decreases the Sinemet dose, it takes a while to arrive at > a new balance. > > Increased doses tend to have an increasing effect for up to six months > -perhaps even longer. This is recognized as lighter "Off" periods and the > "On" tending to string together again. > > Decreased doses at first tend to increase the amount of off time in the > ensuing days. With further time on a lowered daily intake (in terms of weeks > usually) off time tends to decrease again and establish a chronically lower > level of function and side effects. The lower level sort of begins to take up > the slack and make again a mobile situation. Off time again decreases. > > This chronic effect happens very slowly > > Regards, > WHH 54/18 > > > Hello William, I am surprised and puzzled by what you are saying here. Is it a result of your experience, or are you quoting someone else? You talk about the Sinemet acute effect giving several offs and ons per day. I would say that is clear evidence that the size of the doses is too large, and you are swinging from Off to On as a consequence. Why don't you try an intermediate dose to try to hit the target more precisely? After all, there is no rule that says that we come conveniently calibrated in 100's of milligrams. My personal 'magic number' is 37.5 mg/hour. I suspect that a similar mechanism is at work on your long-term problem. I have been following the techniques which I advocate in my writings for seven years now, and over that time, I have consistently taken my 37.5 mg/hour of Madopar, combined with a progressively increasing quantity of Pergolide - This being necessary to keep pace with my steady deterioration as we all do, courtesy of Dr Parkinson. I would be interested in your comments, Regards, -- Brian Collins <[log in to unmask]>