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On Thu 13 Aug, Debbie White wrote: > I wrote last night because my mother Joyce (68/1 year) is having a tough > time right now and her doctor suggested that she may have some other > Parkinsonian disease. After receiving reading some informative pieces > suggested by some on this list, it seems to me more and more that she has > PD. >(snip) > > What I think is confusing the issue is that my mother doesn't (never has) > have clear on/off periods. However, I don't think one can conclude from > this that the drugs aren't working. So my next question is: Isn't it > possible to say the drugs are working without feeling them kick in? Any > thoughts? > Debbie White > [log in to unmask] > > > hello Debbie, I remember well the time whwn you joined us and had us running in circles trying to understand your mother's stmptoms. Sadly, I can only conclude that she has one of the more rapidly degenerating varieties of PD. because of the unexpectedly high dosages of drugs which she has tried. But let's take a deep breath and think about it; in particular the business of switching off and on. In my long experience, noticeable switching (say less than 5 minutes from heavily off to noticeably on has only come to bother me in recent years: I would not really expect a 1 year ( or even a 5 year PWP) to even know what we are talking about. (one point I should clarify is those unfortunate people who have been told to take a large dose of levadopa in the early morning to 'Kick Start' their system. Of course they will detect a noticeable off/on effect, because they are rushing from underdose; right through the control point ( the place they should have aimed for), into a heavily overdosed condition. I now have abstracts from 2 or 3 recent papers which are coming round to the conclusion that forcing levels of levodopa above the minimum required can cause more 'wear and tear on the Dopamine system. . The 'soft landing 'of early stages PD is explainable quite easily: It is due to the one thing which we know fairly well, that a newly diagnosed PWP has (about) 20% of his/her Dopamine-producing cells intact and functioning. It takes a LOT of levodopa to overwhelm that 20% of 'normal cells. What I am suggesting, Debbie, is that it may be worth going back to minimal or no doseage of any Parkinson's medication for 48 hours (Not a pleasant prospect, I know), and starting afresh. What do you think? Regards, -- Brian Collins <[log in to unmask]> -- Brian Collins <[log in to unmask]>