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On Tue 12 Jan, William Isbell wrote: > I have a question for you out there in PD land. One that you're better > able to answer than my two neuros, who seem to disagree. (Not that you > won't disagree. But the List advice frequently is the more knowledgable.) > > How do you determine the proper amount of medication for yourself? > > As a relative newbie (64/0.5), I'm still experimenting with my Sinemet CR > 100/250 (3/day) and Sinemet 25/100 (as needed) dosage. Since Sinemet > reduces my symptoms, why not take more of it? Perhaps much more. Five > times, ten times? > > There must be a downside, but my Drs. are not clear on what it is -- > possibly because of the different reactions people have to the drug. > > Does increased dosage make the long term usefulness shorter? > Is there an overdose limit, where side effects appear? > > I appreciate your advice. > > Bill Isbell > > > Hello Bill. I can and will give you some very specific andwers to your questions. Explaining those answers may be a bit more tricky, and I will have to take you on a journey to a Web site in the UK to deliver the full explanation. First: The answers - 1/ How do you determine the proper amount of medication for yourself? - I wrote a computer program to help me sort out the many interactive aspects of the job. I believe the program to be unique. 2/ Since Sinemet reduces my symptoms, why not take more of it? Perhaps much more. 5 times ? 10 times ? Absolutely NOT !! The optimum dosage is the minimum necessary to do the job. (The job being defined as that which makes you feel like you used to BP (Before Parkinsons). 3/ Does increased dosage make the long-term usefulness shorter? That is an easy one to answer, but a very hard one to prove. It is my BELIEF that you do the minimum of damage by using the minimum dosage, and it is my belief that prolonged, continuous overdosing can produce a sort of burn-out in later years. However, no-one is going to get me up there where I would need to go to collect the evidence! Note however, that I do not accept the nonsense that many neuros utter about unpredictable Off and On periods after prolonged usage, especially when they use that superstition to withhold levodopa (Sinemet, Madopar) in the early years. 4/ Is there an overdose limit, where side effects appear. Yes, most definitely. However, in the early years, you would have to take an enormous dose of Sinemet to provoke it, and there is no reason why anyone should bother. In later years, say 6 to 8 years, that margin comes tumbling down in what looks like an exponential type of curve, and you will begin to understand what all the fuss is about. Simon Coles, who runs a web site in the UK (see the URL below) has kindly allowed me space to explain my theories. The bit that is relevant to this discussion is what I call my Model of the Dopamine system. Note that I do not claim that the brain works like this - As an Engineer, I express it in engineering terms. I believe it to be a good model, because I have found it capable of generating answers to questions which I have thought of only after the model was specified. Now the hard bit: Read my web pages (It is not very technical) I have discussed this with local neurologists, and their reactions have varied from Suggesting that I publish it, down to baffled amusement. See what you think. By the Way, my credentials are Age now : 59. Diagnosed age 39. First symptoms age 33. I ran the first generatio of my computer program in 1990, since when I expect about 1 hour per day either Off or overdosed (Usually because of meals or because I get complacent and forget to tame a tablet on time. Comments are invited. Regards, -- Brian Collins <[log in to unmask]>