[geraldo]

What is the best way to determine the correct dosage of sinemet? I know it is going to be different for each person, but is it strictly a trial and error game or what? My mds started me on one 25/100 four times a day and has me fill in a questionare each visit and asks about "end of dose" wearing off but I haven't talked too much about it with him as yet. My mail order med supplier gave me the generic sinemet made by "Teva" that did not work for me so after some research on the old BT site befor the big crash I found out the brand (BMS) works better and ordered a new perscription at four times the price, but the brand name work so much better its worth it. In order to make use of the old (teva) sinenet I started adding 1/2 tab four times a day. My doc seemed to think this was ok--BUT I feel even better if I uuse 1/2 the branded pill. Next time I get a new script I'lll ask for an increase of pills.
How do you determine the dose and interval of your sinemet?

My current meds are sinemet,and coQ10,curcumin,fish oil,vit- E, multi-vit and EmergnC

geraldo

[wendy s]

This is a great question and one I'm wondering about as well. Right now I'm thinking you should take as little as you can, and still function and be comfortable. That's because I don't want any more dyskinesia than I have to have later on.

On the other hand, many think that you should keep the level of dopamine as steady as possible to decrease dyskinesia So right now, my "more on" and "less on" periods are probably not ideal. (I'm not sure I can really call what I experience being "off", I'm just not as good as the meds wear off after three or four hours.)

Right now I take three doses a day, and try to avoid other people between 12:00 and 1:00 or so. Probably if I took four doses, I wouldn't have those less functional times. I see my MDS at the end of Jan. to talk about this, but am looking forward to reading what others on this forum say. Sometimes I think the body of knowledge on this forum is greater than his!

[aftermathman]

exactly right on the less strength doses more often.

My Neuro's key take home message from the recent European PD conference was less drugs more often is more effective than more less often.

Aftermathman.

[geraldo]

Thanks Wendy S and Aftermathman. I do find that if I time my doses carefully, I feel better. I have found it easier to streach between dose time in the less active evening hours. You must not burn up ldopa as fast surfing the net or watching the tube.
geraldo

[BEMM]

I'm surprised that you started out with Sinemet, Geraldo. Many neuros start you off with an Agonist before adding Sinemet.
I've been on meds. for 6 years. It took four years to find a mix of meds. that worked maximally for me. My daily cocktail of drugs is 8 1/2 mg Requip, 1 1/2 Teva lev./carb. 25/100 mg. pill, and 100 mg Amantadine (for bad balance), divided in 3 dosages. I have taken this same amount for the last two years, and I feel better now than I did two years ago, when I was taking more Requip and no Sinemet.
It seems a rather high dose your doctor has prescribed. I agree with Wendy and aftermathman that it is best to go slowly on Sinemet. Many have horrific problems with agonists, but if they agree with you and help, you can be more conservative with the Sinemet, and the agonists don't give you dyskinesia. You might experiment with a mixture of meds. instead of relying entirely on Sinemet. Just please read the warnings of side effects. Artane f. ex. I would not want to risk taking.

birte

[lindylanka]

Hi Geraldo,
I am like you - only on Sinemet, currently taking 3x100/25 ordinary sinmet, and same dose 3 x sinemet 1/2 cr. But in 3 doses unlike your 4. I have been on this dose 2 1/2 years and it keeps me stable especially if I can keep it very regular. But I tend to get my timings all messed up at this time of year. My new neuro seems to think this is quite high for this stage, and probably will want to bring in some other drug, agonist maybe when I see him next. It definitely helps to keep everything very even throughout the day, and from what I have read that is a key to keeping dyskinesia at bay, though with this disease nothing is a certainty.

Perhaps it would be better if you only added 1/2 to your most active times of day rather than with each dose. I was warned off taking regular sinemet close to bedtime - it can interfere with sleep patterns. I have gone higher a couple of years ago, for two weeks when I was working quite intensely, but it was very hard when I dropped back down again, which did not manifest immediately but after a few weeks resulted in lethargy and some cognitive issues, which took several months to shake off. It is easy to feel great on sinemet, but levodopa has a major effect on how we function so it is best to be cautious in the way we use it.

I would discuss options with your neuro. Is there a reason why you are on sinemet only? I was working when I started and my first neuro thought it would interfere less cognitively. There are loads of reasons for why our meds are all so different, let us know.......

Best wishes with finding a good balance of meds which works for you.

Lindy

(I am just starting to feel as though I need something to take me through the night and would love some advice on how I could manage my current dosage, but take it over 4 doses rather than 3. But am not sure how to do this as the CR is definitely preventing wearing off symptoms, and I do not wish to take the regular at night time, and there is the little problem of how to divide 3 tablets of each over 4 doses.....)

[stevem53]

geraldo..TEVA didnt work for me either, and as a matter of fact it made me worse..I now take BMS..But Ive heard that the other generic brand ENDO works..I havent tried it but I know some folks who have..Food for thought..I currently take 3x25/100 Sinamet and 2x.25 Mirapex daily..dx May 04

[chasmo]

an Australian lady takes liquid sinemet on the hour. She went from a wheelchair to doing an aggressive workout. She believe's in "retraining her neural pathways". SHe jumps UP stairs now!!

The point I am making is that whether it is an abdominal pump or taken hourly in liquid form, small easily assimilated dosing is preferable to pill form.

IF any of you are have "end of dose offs", I'd try this form of doseage. I think it holds great promise.

Charlie