Originally Posted by johnt

proudest_mama,

You write "I'm taking .25mg three times a day". This is a very, very low dose, which I don't think anyone would prescribe. Do you mean a quarter of a tablet? If so, what is the levodopa dose of the tablet? If I understand your details correctly, you're 12 years after diagnosis. To have gone so long without taking levodopa is either a good sign - if for many years you didn't need it because you had progressed very slowly - or a bad sign in that you missed benefiting from levodopa for years. What other anti-Parkinson drugs do you take?

1. Once you reach your final dose, you can expect the drug to have an effect in about 30 minutes. But as you titrate up to that dose, you may be taking too little to have a noticeable effect.

2. Feeling worse with a small dose than no dose is something I experience. Sometimes I'll be awake and at the laptop most of the night, long after my levodopa has run out (but still within the "range" of the agonists that I also take). I can type, albeit slowly. I put this down to me still having some dopamine producing neurons. But, after I take my morning dose, to begin with things get worse until the dose kicks in and things improve. I put this down to the levodopa either inhibiting my own dopamine production or else clearing it.

3, I think that if you do not respond to a substantial dose of levodopa, you should have you're diagnosis checked.

4. Your dose schedule is not uncommon, but does have the problems that you mention. Levodopa has a short half-life so after 3 to 4 hours it's all gone. However, if you're not too far advanced, your neurons should contain large enough reservoirs of dopamine which together with the locally produced dopamine should tide you over. As the disease progresses you can expect to take more doses.

John