Bubblyshar,

I'm not a doctor, but make of this what you will.

I notice that your dad's daily dose is quite low, 300mg of levodopa, for someone 6 years post-diagnosis. Nevertheless, I'm still surprised that you don't see him getting any relief. I would run the side-to-side finger tap test on him every 15 minutes during a drug cycle. If there is literally no relief, I'd get back to the doctor. If there is some relief, but insufficient, I would consider increasing the total dose by increasing the number of doses in a day. Perhaps, looking at agonists and rasagiline which have the advantage of spreading out the therapeutic impact, but have the disadvantage of worse side effects.

Regarding the constipation. I suffer from this badly (which suggests my ideas on the subject are not worth listening to). More fibre in the diet simply blocks me up more. More liquid is good, but easier said than done - I rarely feel thirsty. Movicol, a powered gel, does some good if I take it frequently throughout the cycle - but, I can't stand the taste. My most effective response is a water enema - but the advice from medics is that these should not be used regularly.

Finally, the constipation may be one of the reasons that Sinemet is not being as effective as hoped for.

I have no ideas about the cough.

John