[dwyerk60]

Hello,
I am writing as a daughter of a mother (age 76) with PD (12+ years). She has somehow ended up taking 16+ Sinemet a day (2 tablets 25/100mg every 2 hours upon waking). This seems extremely high and well beyond the what is recommended. She 'lives' on pills and her quality of life is diminishing every day.

She also takes 20mg a day of Celexa to deal with the depression. She used to be so active and social and is now isolated in her apt. Several times a day she also has 'spells' or 'episodes' where suddenly her jaw will get stiff, her hand will cramp up, her walking is impaired, her breathing increases and she has to lie down (this year she started taking 1mg of Ativan three times a day to try and combat these spells). Once the spell is over she can resume a routine.

WE are at a loss but now wonder if the spells may be related to the high dose of Sinemet she takes?

Any thoughts? Comments? Getting desperate to help my Mom!

[Jomar]

Sometimes you just have to ask the dr if any adjustments can be made, or other combinations can be tried.
Different docs have different ideas too...so ask and see what they say..

My dad has had PD about the same length of time.
For his PD he takes -
* sinemet (generic carb/lev) - 8-10 per day
* a very small dose of Mirapex that works to enhance the sinemet - too much caused hallucinations, and with none was nearly recliner bound & extremely weak...

[dwyerk60]

Thank you Jo. We live in northern MN so unfortunately we have limited specialist that really understand PD! We have a great nurse practitioner but she remains perplexed about my Mom. We do think she is overloaded with Sinemet and that may be bringing on these spells. More to discover!

[soccertese]

HI, 1600mg is high. was this a sudden increase in doseage/decrease in your mother's health? how involved are you with your mother's treatment, will her dr. talk to you? do you have a support group in the area you can attend. her medication is just one issue with pd.

i'm not a medical professional so won't jump in and say taking 1600mg is too high but noone wants to take medication every 2 hrs, especially at her age and condition.

there are longER lasting parkinson's meds called agonists where you need to take fewer pills but doctors don't like to prescribe them to people your mother's age because of potential side affects such as hallucinations. they are used by 76 year olds though.

just general things to look at if sinemet suddenly becomes less effective is slower gastric emptying - the longer sinemet stays in the stomach, less gets to the brain.

constipation slows gastric emptying as does dehydration.

changing generics, remote possibility but worth checking.

the national parkinson's foundation has a help hotline
http://www.parkinson.org/about-us.aspx

[Ling2]

It may be the result of overdosage ...remember sinemet is chemical and human body has a maximum capacity to safely house this drugs , though different people has different capacities. Mine is about4-5 sinemet a day and beyond thus thresholds dystonia will be very serious ....

Originally Posted by dwyerk60

Hello,
I am writing as a daughter of a mother (age 76) with PD (12+ years). She has somehow ended up taking 16+ Sinemet a day (2 tablets 25/100mg every 2 hours upon waking). This seems extremely high and well beyond the what is recommended. She 'lives' on pills and her quality of life is diminishing every day.

She also takes 20mg a day of Celexa to deal with the depression. She used to be so active and social and is now isolated in her apt. Several times a day she also has 'spells' or 'episodes' where suddenly her jaw will get stiff, her hand will cramp up, her walking is impaired, her breathing increases and she has to lie down (this year she started taking 1mg of Ativan three times a day to try and combat these spells). Once the spell is over she can resume a routine.

WE are at a loss but now wonder if the spells may be related to the high dose of Sinemet she takes?

Any thoughts? Comments? Getting desperate to help my Mom!