Hi Sara,
Your father is starting to see dyskinesia at peak dose now. You don't say how long he has had PD, but I guess about 10 years?
I agree with you, to even out the dose to avoid such a peak. I would not think the doc would have any objection to spreading out the dose, since he would be taking the same amount per day. Is your father on an agonist, eg MIrapex or ropinerole?
A drop in sinemet of 750mg to 300mg is very steep. You always need to do things gradually. I assume the 250mg sinemet tablets are controlled release? I don't like splitting controlled release tablets. They can lose their controlled release properties and give a sudden high. Can you persuade your neurologist to prescribe 25/100 sinemet and spread the dose more evenly over the day. Then you have more control over the diilema of dyskinesias
versus imobility. If he is not taking an agonist, adding one would help to reduce his sinemet slightly.
Is your dad taking any supplements? Robert has some good suggestions, and adding curcumin could help, it is a cheap supplement and does seem to slow down progression.
Do make any changes gradually.
Ron
Quote:
Originally Posted by Sara259
Hi Ron,
Thank you for sharing your experience. I have been searching for information on reducing/withdrawing from Sinemet and haven't been able to find anything. My father is on 250mg Sinemet 3 times a day. He has been on this level of mediation for a number of years. Over about the past 12 months I noticed that at about the time the peak dose of Sinemet is in his system (about 1 - 1.5 hrs after taking it) he experiences jerky movements, walks differently with his left arm out behind him to balance, his balance suffers badly and his eyes are wider and staring, he isn't himself. This lasts for about 2 hours. Then it is as if the dose in his body adjusts and he is great (can go for a short jog etc), everything is fine - until he has to take the next dose and it starts all over again. His GP was initially supportive and told us to reduce him to 100mg Sinemet 3 times a day (quite a big jump) and for the first 3 - 4 days he was great - none of the symptoms previously described. He lasted on this lower dose for 10 days, by the end of this trial the excessive saliva production was really distressing him and he felt much slower, couldn't turn in bed etc etc. That was back in May and he went back on the 250mg. His neurologist saw him last week but only in his "good period" and won't change his meds or recommend a reduction. I still think the 3 x 250mg Sinemet is too high for him - surely the evidence of these symptons only on the higher Sinemet dose are an indicator? I am thinking about suggsting he try splitting up the midday dose (half 250mg at two intervals instead of the whole tablet at once). I was wondering whether you have ever had to stagger your dose in this way?
Sara
Australia
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