raleighaodh,

Dystonia happens when I'm off. When sinemet kicks in, dsytonia goes away. I have trouble with my right foot tho even when on. I have so much trouble with my right side it's hard to say why.

Anyway, only l-dopa relieves it but I have found that taking nortriptyline relieved my morning off to a great degree [don't even have it sometimes].but i've also added stalevo recently and feel better with these two meds.

I think another transmitter is greatly in play in pd , acetycholine. When there is too much of it and when it is out of balance with dopamine, it causes muscle cramping and other movement problems. When off, I wonder if too much acetylcholine could cause the conflict of pushing and pulling that could be dystonia.

My dystonia is in my face,neck, shoulders, back, and feet. It is common in pd. Nortriptyline has anticholinergic properties, is a nerve pain killer and anti-depressant. Other anticholinergics [ which aid in the slowing up of too much acetylcholine] are Artane and Cogentin.

If anyone knows of more please add.