I am in full agreement with Janet on the subject of delaying Sinemet. It is
one of those situations where someone happens to start a trend (with nothing
to support it, and all the other lemmings surge into action. And 40 million
lemmings can't be wrong, can they?
In this example of ludicrous logic, I have managed to put together what I
think is the reasoning (or should that be unreasoning) which led to the
witholding of levodopa fashion:
1) It is well known that you can't achieve a satisfactory control of PD
symptoms with Sinemet beyond about 7 or 8 years, due to the dyskinesias and
'motor fluctuations'. I haven't heard a decent definition of Motor
Fluctuations, but never mind, it must be a really bad place to go.
(By the way, I controlled my symptoms quite acceptably for 14 years, by
a rational and careful application of Sinemet, and have written quite a
lot about the subject, but I doubt if any professionals have understood my
arguments.
2) Here it comes, the giant leap for mankind: The Sinemet would behave
much better at the 7 to 8 year point, if we avoided using it at all in the
early days of PD. How? Why? Where is the reasoning? There is none because
the whole proposition is ludicrous. Have they forgotten that we are dealing
with PD here? I doubt that anyone in the world of PD has ever made the
slightest impression on the rate of deterioration of anyone's PD symptoms
(Of course, there is a range of deterioration rates, but each person's
rate is his own, and there is no changing it.
That rate of deterioration has nothing to do with Sinemet:it is loss of brain
cells which is the cause. By the way, I forgot to mention that I took Sinemet
alone for 14 yrs, And I took Sinemet for all but the first year of PD, AND
I still take Sinemet 800 mg/day of levodopa at 21 years since diagnosis!!
Witholding Sinemet in early PD is stupid, and it doesn't work. Of course
proving that it doesn't work is virtually impossible because you can't go
back and try again. It has to be done by logic, and I have done that - not
here, I've just indulged myself by letting off some steam in this e-mail,
but you can if you wish follow my more rational writings in the following
web site
http://james.parkinsons.org.uk/brian.htm
Happy reading,
Regards
--
Brian Collins <[log in to unmask]>
