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Hi Brian , I believe that you probably as it is said that " hit the nail right in the head" .... :-) I have read frequently that levodopa is not very effective in the control of tremors . Would you like to comment on it ? ( as I am one that appreciate yours comments) Regards , Brian Collins wrote: > On Wed 09 Jun, Callie M. Judd wrote: > > having some problem with dyskinesia so we hoped to reduce the Sinimet by > > taking > > Bromocriptine too - but so far no luck on any reduction- > > We've tried three times before to remove the final 1 mg. Cogentin > > since we > > feel it contributes to his difficulties with constipation and hallucinations > > - but the > > tremors have always been under good control. We are now in the process of > > trying to reduce the Cogentin gradually enough to discontinue it but we > > aren't sure > > if the Sinimet & Bromocriptine will keep the tremors away. We will be keeping > > track if his ongoing but mild hallucinations leave him as we reduce the > > Cogentin, > > (we don't know for sure that the hallucinations aren't caused by the Sinimet > > or the > > Bromo - but the Neuro says the Cogentin is not supposed to be doing him any > > good anymore) The reduction will take about 3-4 weeks - will let you know > > the > > results - if he has to stay on it, it will be a good bet that nothing else > > he's used > > does well against tremor. Any other Cogentin users out there having > > "withdrawel" > > difficulties - using it for tremor reduction?........ > Marie, I think you have missed the main culprit: The cause of your husbands' > dyskinesia is the Sinemet CR. The vital parameter in takng Sinemet is the > rate of flow of levadopa. Here are some typical values: > > Quantity l-dopa Duration Rate of flow > > Ordinary Sinemet plus 100mg 2 hrs 50 > > Sinemet CR 200mg 4 hrs 50 > > Sinemet LS 50 2 hrs 25 > > You will see that the popular tabs give the same rate of flow. You need > a certain rate of flow to make up for the missing dopamine cells output. > I will quote my figures, but yours will probably be in the same general > area. My 'bottom line' rate of flow is 37.5mg per hr. Below that value, > I get 'Offs' - above it I get Dyskinesias. Keep in mind that you have > no control over the timescale: all you can do is vary the size of the > dose. > > The next point is that you cannot influence the l-dopa-caused dyskinesias > by juggling Cogentin or anything else except l-dopa. You must get the > Sinemet right first, then worry about the rest.-- +----| Joao Paulo de Carvalho |------ + | [log in to unmask] | +--------| Salvador-Bahia-Brazil |------+