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Brian, having just started on SinemetCR 25/100 three times a day, what are your views aboutSinemet vs. SinemetCR? [log in to unmask] ----- Original Message ----- From: Brian Collins <[log in to unmask]> To: <[log in to unmask]> Sent: Tuesday, November 09, 1999 5:50 PM Subject: Re: Mirapex side effects / delaying sinemet > 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]>