To recap, I use the term "dynamic dosing" to mean a drug regimen involving taking variable doses at varying times, from one day to the next. The decision of when to take a dose depends on need and bioavailability.

Dynamic dosing contrasts with the normal dosing regimen, which is static. In a static regimen there is a fixed schedule from day to day e.g. 100mg dose of Sinemet at 0800, 1100, 1400, 1700. Static regimens can become sophisticated, with a PwP using a variety of different drugs with the aim that their combined effect will, due to their differing half-lives, lead to levodopa equivalent levels which are more stable. See:
http://neurotalk.psychcentral.com/thread169655.html

What dynamic dosing means in practice for me is that the timing of my doses during the day is flexible. Even the timing of my initial dose is not fixed: I tend to wake up feeling pretty good and can sometimes go several hours without feeling the need for any drugs. My initial dose of the day serves two purposes: to get "on" as quickly as possible (for which I take 75mg of Stalevo) and to lay down the foundations of a relatively stable base load of long half-life levodopa equivalence (16mg of ropinirole CR and 1mg rasagiline).

My later doses are taken when I feel that I need them. There are several constraints: I will not exceed, except in special circumstances (usually high exercise days) another three 75mg Stalevo pills; I will not take a pill within two hours of a previous dose (this is usually an issue because I have "lost" a dose, due to, possibly, too much protein in a meal); I try to avoid taking a dose within one hour of eating.

The leading indicators that affect the decision of whether or not to take a dose at a particular instant varies from person to person and from time to time. For me, presently, it is an increase in left hand tremor which tells me that I'm about to go "off". But, even if I take the next dose immediately, this warning comes, perhaps, 15 minutes too late to avoid going into a weak "Off" before the next dose takes effect. I also take into account whether I need to "perform" (for instance, go through an airport). If I am, I take the next dose early.

I have been building a computer based system to improve the timing decisions of when to take new doses. My system uses an Arduino micro-controller to pick up readings from an accelerometer placed at the back of the head. (This spot was chosen because it seems to be the best place to identify bradykinesia. The hand is a bad choice for this purpose, because of the arm swing while walking and the prevalence of tremor. Notice that my human control decision is based on tremor, but the computer based system is based on bradykinesia.) The whole package measures 2 x 5 x 7cm. It is fixed inside a hat. The prototype is obtrusive, but any production version would be far smaller, and I think cause few problems.

Are there any other dynamic dosers out there?

John