Originally Posted by arin

My father has been a parkinsons patient for 7 years now.

since he was 43.

He has recently been overdosing on tablets, taking up to 1800mg a day in sinemet, azilect, and sinemet cr

he had been self medicating not following doctors plans, and started to develop erratic and disturbing behaviour, doing irrational things, and feelings of paranoia.

the doctor has reduced his dosage to 1000mg a day , from 7am every 1 hours taking 100mg

i did a thread where your question is similar. i firmly believe after 4 months of research everyone with pd and their caregivers should read "once upon a pill" at least for a different view point and then decide for yourself if it can help you with your situation. it talks of the medicines pd'ers take, what some have done to decrease their meds, strategy wise what worked and what didnt. plus it describes clinically what the phases are "on/offs" among others. google the title its a free download and its segmented into chapters. you can start by reading each chapter summary to give you a feel if it has what you need. it is written for the layman. and do read the footnotes on each page they are extremely helpful too and integral to the meaning. it was the one resource i found that has helped me understand and make a strategy off of. according to amazon it is out of print so if you research it and find a place to get a hardcopy. let me know i want one.and there is an adjustment for the body according to the book.good luck and please post what you learn it might help me and others. thanks.

however he has had 2 days where he has been off pretty much all day.

is there adjustment period for the body?

Originally Posted by Conductor71

Yes, there is a big adjustment when you are on any dosage but especially when higher up. Did his doctor just cut out 800 mg in one day?

If so, you need to watch your dad closely for something called Neuroleptic Malignant Syndrome - key symptoms are high fever and all over rigidity. This happens to some people who are taken off their PD drugs too abruptly, and reducing his dosage in half is too much too soon.

You can expect what doctors call symptom rebound - a withdrawal effect where his symptoms will be much more intense and uncomfortable. I went through this and it lasted a good month; I also had new symptoms temporarily appear. It is alarming to hear of doctors doing this; with neurologists there is no excuse.

Long ago in PD Land, doctors used to put patients on "drug holidays" and when they noted patients actually dying from it they ended the practice. Any patient should be slowly tapered down over the course of weeks if not longer. Our brains become dependent on the dopamine boost and to suddenly take a good portion of it away is not so good- just common sense. The brain and body need time to adjust accordingly.

Don't mean to alarm but just want you to look out for him, as most doctors won't. If he gradually worsens over days; that is more like a symptom rebound. He will probably his his baseline and be okay but if you do note any sudden rigidity, unexplained fever, it is serious.

Here is a good overview; it is not uncommon that doctors bring this on.

Infections, drug changes can bring Parkinson's to the ED. (ER)

Hope he "normalizes" and finds relief soon.

Laura