Originally Posted by johnt

soccertese has made a good find.

I'm of the opinion that, given the glacial progress being made in the introduction of new treatments, anyone who has had PD for more than 5 years is likely to gain more from optimising their (unique to them) response to existing therapies than banking on a breakthrough getting to them in time to make a difference to their prognosis. Given this, I recommend that PwP read this paper.

In the paper Lees gives many tips: some well-known, such as not taking levodopa drugs with protein containing foods; some less well-known, such as:
"If the start-up time in the morning is slow following the first daily dose of levodopa it is useful to instruct the patient to grind up or dissolve his first daily dose and imbibe it in a sweetened drink. This can improve the speed of response by up to thirty minutes." [Note: do not grind up controlled release medications.]

I always thought that the decreasing response to levodopa over the years as the disease progresses was due to the decrease in the brain's ability to store dopamine. However, Lees writes:
"progressive reduction in the storage capacity of surviving nigrostriatal dopamine terminals is not a critical factor."

Finally, it is interesting to note that this paper was written in 1989 and they were talking about the levodopa pump then.

John