 |
 |
I intended to send this reply to the list, but forgot the new system. So here it is (one or two days late) Brian Collins On Mon 22 Mar, Nancy S. Shlaes wrote: > I was diagnosed almost 5 years ago and at that time was started on three > whole 25/100 Sinemet and 10 mg. eldepryl. > > Currently, I take one-half tablets of Sinemet 25/100 4x/day, plus 5 mg. > eldepryl and .5 mg of permax (3x/day). I have had mild dyskinesia on > and off for a couple of years, but nothing serious. I do not have a > tremor and have never had one. My shuffle etc. is pretty one-sided, but > moving to both sides. > > My problem: within the last two weeks I have developed a wild > dyskinesia which gets worse every day. It is primarily in my feet (more > left than right) but my whole body is involved. I can't tell whether it > is peak dose or end-of-dose or both. Taking the sinemet doesn't seem to > help--nor does it make it worse. > > The dyskinesia begins when I wake up in the morning (I used to have a > fairly PD-free early morning) and immediately is very bad. So far, I > have no problems with dyskinesia during the night , although I sleep > less and less. (I used to have Restless Legs Syndrome but the permax > seems to have helped that alot). > Nancy Shlaes deGrazia 62/dx57/symptons 54 > Hello Nancy, I think I can see what is going wrong, but first, I think we need to define some terms. First, I think that what you are experiencing is not Dyskinesia. - Dyskinesia is the brain's reaction to excess levodopa , but you are not taking enough Sinemet to provoke that reaction. Bearing in mind that you are 5 yrs into PD, (and maybe earlier symptoms? your problem is not enough Sinemet! and I think your symptoms are plain old Vanilla flavoured PD tremor. The duration of the standard 25/100 Sinemet is (for me) about 2 hours.You, being relatively 'new' to PD may get 3 hrs if you are lucky. I am not sure how you deploy your tablets during the day, but I guess that it is about 1/2 a sinemet 25/100 every 4 hours. If that is true, then you are getting an hour at least between each tablet when you are effectively on zero Sinemet. The ups and downs which you get, apart from the discomfort, may be bad news in the long term. What you need to do is progressively reduce the time between tablets until you sense that you have effectively overlapped two tablets. (You may then get to know what Dyskinesias are (!)) You don't want that either, so go back a little and fix that time interval in your rulebook. That should, (if my initial conclusions were correct) set you back on the road fr a few more years. never forget that PD just keeps on keeping on, and you need to stay flexible to be able to respond quickly. Regards, -- Brian Collins <[log in to unmask]>