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Dear Mark, There are many possible reasons for the increased "down" or "off" time, and your neurologist should be able to workwith you on this. One thing to mention, though, is that Sinemet CR is less bioavailable than regular Sinemet; so, although it may even out the fluctuations, it may also have less effect. There is also the possibility that protein later in the day may be contributing to part of the off fluctuations. If you aren't already doing so, taking the Sinemet 30-60 minutes before meals may help. Some of my clients have used the same schedule you did -- regular Sinemet first thing in the morning to help get them started. Then they use CR the rest of the day, taking it well before meals. Many have had quite good results. Best regards, Kathrynne Mark F. Hardy wrote: > Help - I'm having severe 'down times' and am looking for ANY suggestions or > ideas. I was taking 1 sinemet 25/100 about every 1 to 1 1/2 hours, .5 mg of > Permax 3 times a day, one 5 mg Eldepryl, plus a vitamin C daily. > > I was starting to experience longer down times than I was used to - before, > I > could pop a 25/100 Sinemet and with-in 15-30 min's I was back to > functioning. > Then my nuerologist decided that maybe 50/200 Sinemet CR (time released) > would level out the down times, so he switched me to CR, plus I upped the > Permax from .5 to .75 mg (still 3 times a day). At 1st, it wasn't so bad, > but then > I noticed that when I 1st got up, the med's were taking longer to get me > going. > So, I called the nuero and convinced him to let me take (in addition) 1-2 > 25/100 > Sinemet 1st thing in the morning. That seemed to work, at least for getting > me > moving (unfrozen) 1st thing in the mornings. > > I ran out of the 25/100's and decided that I should REALLY try to get by > without > them. My down time (frozen) has continued to worsen, to the point now where > it > may take me 2-4 hours to get out of the frozen state - now, if I forget to > take my > med's, I can expect a longggg down time. This sudden drastic change is > scaring > me - am I doing something wrong, has my PD taken a turn for the worse, or > what? > > What else is different? I just had disc surgery and can't sit for 6 weeks. > No med's, > just have to take it easy. > > HELP - mark -- Kathrynne Holden, MS, RD "Nutrition you can live with!" Medical nutrition therapy http://www.nutritionucanlivewith.com/ Tel: 970-493-6532 // Fax: 970-493-6538