Thank you Soccertese! It sounds like you have had a slow progression, on a low dosage of Sinemet. Do you attribute the low dose of Sinemet to not having dyskinesia? I really appreciate all of your advice and the gentle reminder about the advantages of Sinemet. I will take it all into careful consideration. I just have been impressed by all of the positive research on DXM and it's symptom relieving properties. Apparently, it is proving to have benefits for many diseases. ie. In ALS, it is beneficial in speech, swallowing, incontinence, anxiety...
Not to mention, it's potential to have neuro protection and reduction of
Dyskinesia in PD.
I think RLSmi's slow progression is a testament to DXM. 14 years since dx, DXM taken for 10 of those years and he only has slight dyskinesia...imo, that says encouraging, as well.
http://www.ncbi.nlm.nih.gov/pubmed/9674803
Dextromethorphan improves levodopa-induced dyskinesias in Parkinson's disease.
With DM, average and maximum dyskinesia scores improved by >50%
This is a more recent paper with free PMC article:
http://www.ncbi.nlm.nih.gov/pubmed/21052935
Neuropsychopharmacological understanding for therapeutic application of morphinans.
(Dextromethorphan is a morphinan derivitave)
This review will demonstrate novel neuroprotective effects of several morphinans such as, dextromethorphan,
The fact that DXM is already an FDA approved drug with proven safety and efficacy...taken in recommended doses, over the counter & inexpensive is very appealing.
We are definitely going to wait and talk to our MDS before doing anything. Btw, our MDS is Stewart Factor at Emory University.... He is an amazing doctor if anyone ever needs an MDS in Atlanta, GA. You recently posted a link to his video presentation in reference to PD Research Trends. He told us the same exact thing that you said about meds being a trade off between quality of life and potential side effects. We feel very fortunate that we found him early in diagnosis and that he didn't push Sinemet right away. Before we knew to see an MDS, we saw a regular Neurologist, who prescribed Requip the very same day as dx. By that night, my husband "literally" thought he was dying. We almost ended up in the emergency room - it was awful! Please don't take that as my saying Requip is bad. I know it helps a lot if peolple! Apparently, some people have an adverse effect to agonist and he is one of them. The point is, that his only symptom at the time, was slight hand tremor and reduced arm swing....he really did not need to be medicated. For the record, I agree with yours & Dr. Factor's philosophy implicitly. I can see what a difference Sinemet has made in so many lives and hope my husband tolerates it, as well. We just want to make sure we have exhausted all other possibilities before making the plunge. One reason is due to the statistics of age at PD onset & dyskinesia. He was 40 when diagnosed and statistics show that dyskinesia is 70% more likely after 5 years of Levodopa treatment, when age of PD onset is 40 - 49.
http://www.ncbi.nlm.nih.gov/pubmed/20310028?log$=activity
Age of Parkinson's disease onset as a predictor for the development of dyskinesia.
I am happy to hear that MJFF is delving into dyskinesia. It's just unfortunate that a med that can help so many can have such debilitating side affects. I pray they can find an answer! I am thankful that we have Sinemet as an alternative. I also have high hopes for DXM and other meds, in the neuroprotective & dyskinesia arena.
This looks like it is going to be a great paper. Unfortunately, it is " in process" at PubMed, but it has an intriguing abstract.
http://www.ncbi.nlm.nih.gov/pubmed/23172094#
[Levodopa in the treatment of Parkinson's disease: myths and realties].
Take Care!
Cynthia