[madamlash]

Yes, I'm the one that has a dr trying to take me completely off meds... got several very valuable opinions on Neurotalk confirming my own. So, I'm searching around for alternative delivery systems. The whole Neupro thing seems aimed at early PD, which after 6 years, I would not be considered. No one else seems to be working on a patch for us tween PDers. There are some Seligiline patches but that's not the same thing.
So, I did find the following and was hoping someone might know something about this or have an opinion. It sounded like one little dr thinking outside the box, which I wish more would!

Levodopa
Rectal administration
From Dr R. J. Needle, MRPharmS

SIR,-A 70-year-old man was recently treated as an inpatient in this hospital for gastric carcinoma. The gastric outflow obstruction caused by his tumour rendered oral medication ineffective. Tremor due to pre-existing cerebellar atrophy had been controlled with Sinemet Plus, but because of his inability to absorb oral medication, the severity of the tremor was drastically increased, curtailing his ability to undertake activities of daily living.
As an experiment, his Sinemet Plus was administered rectally, which resulted in a marked reduction in his tremor and greatly improved his quality of life. This apparent therapeutic effect is contrary to the only published study on rectal administration of Sinemet or levodopa.1 However, since this unlicensed method of administration appeared effective in this instance, it may be worth contemplating in other patients in a similar predicament.
If anyone else has had experience of using Sinemet or Madopar effectively by this route, I would be interested to hear from them.

Richard Needle
Chief Pharmacist Colchester General Hospital, Turner Road, Colchester, Essex CO4 5JL

Reference
1. Eisler T, Eng N, Plotkin C, Calne DB. Absorption of levodopa after rectal administration. Neurology 1981; 31:215-7.

[michael7733]

http://www.gghbpharmacy.scot.nhs.uk/...L_BY_MOUTH.pdf Here is a table that lists alternative delivery systems for many medications.

[lurkingforacure]

I have read about this on a PD caregiver forum and according to the members there, it does work. It appears to be used only for end-stage, though, or in situations like the one posted about here, where one cannot take oral meds.

To add to the weirdness: we read somewhere, some time back, about someone snorting their sinemet....before you laugh your butt off like our neuro did when we asked him about it, think about this: snorting a med would bypass the whole digestive/absorption problem, and go direct to the brain. He could not/would not help us with this, which was no surprise really, but I was intrigued. I could not find out any more, though, and we're too afraid to crush up a sinemet and try!

[michael7733]

Well, I suppose you can do whatever you want, but I don't think the carbidopa and fillers are meant to go to the brain. It is the levadopa portion that is useful to us in the brain . I do recall that in Europe they were working on a nasal spray as a delivery system, so, that is a definite possibility. As you said , that would completely bypass the digestive system and probably require less medication to achieve the same results.