No response from C-L, inadequate dosage?
 

I was prescribed 25/100 by my neuro and he wanted me to try one half of a tablet once a day for 3 months. I soon gave up on this inadequate anount and tried a whole tablet once a day but still got no response. Should I try a tablet and a half to see if I get a boost. I think my problem with CL not working is a dose issue. CL does not accumulate in the system does it? Btw, looking for a new neuro. Thanks for helping with advice..

both carbidopa and l-dopa should be out of your blood in 4-5 hrs. keep in mind that in the early stages of pd where you still have some functioning neurons in the substantia nigra, those cells will accumulate l-dopa so you don't have wearing off. but there are mechanisms that tightly regulate l-dopa concentrations in the brain. getting too technical here.

how long have you been taking 100mg of C/L? can i ask what the NDC is on the RX label? this is a number with the format like 0093-0293-05.

what supplements are you taking within an hour of taking the C/L? I've noticed taking a multi-vitamin even an hr. before can negate the affect of my C/L, possiby due to B-6.

In the book "THE PARKINSON'S DISEASE TREATMENT BOOK" Dr Ahlskog starts patients with 25/100 C/L 3 times a day.. Some people start with 50mg three times a day but most people can tolerate 100mg. the exception is for nausea. it may take a few weeks to find the right dose.
week 1 - (3) 100C/L stop here if works OK otherwise
week 2 (3) 150c/l
keeping increasing by 50mg up to 350mg 3 times a day - wow!

i guess the point here is this neuro has people start with 300mg/day or if the get nausea 150mg/day. then increases the dosage weekly until the best dose is found. my advice is talk to your neuro, he must have a reason for giving you such a low dose for such a long time. the goal is to get the best symptom relief so you can improve the quality of your life? that said, i noticed a beneficial affect from my first dose of 50mg C/L 9 years ago, i have no tremor. tremor can be drug resistant.

i'm not a doctor so take what i say with caution and talk to your neuro.

Blackfeather,

I agree with soccertese, talk to your neuro.

I would expect 100mg of C/L to get a response. Possible reasons for it not to include:
- the drug's not being absorbed, for instance you're taking the drug close to eating protein or you're constipated;
- you don't have PD;
- your assessment of whether or not it has an effect doesn't have enough resolution, for instance you may have a mild case of PD, with your body's endogenous supplies and reservoirs being almost adequate.

I'd stick with the 100mg dose as prescribed by your doctor. With this dose I'd run a test using the side to side tap test:

Parkinson's Disease Measurement: PwP, surveys, trials, analysis

The first few times that you do this test you learn how to get better results. So, do the test at least 10 times or until the results stabilize, and throw away the results. Then, starting a hour before the dose, do the test every 15 minutes until 3 hours after the dose. To avoid confusion, you should not eat before or during the test, except that you should eat a biscuit and drink some water with the dose (this is to ensure gastric emptying). Draw a graph of the results. A response (a higher number of taps) should be obvious.

John

[tried a whole tablet once a day but still got no response.]

Is this correct? 1 pill a day? :confused:
a generic or a brand name?
long acting /extended release?

Generally c/l doses are spaced out 4 times a day.

Oh here is your older thread with replies on this related topic.
http://www.neurotalk.org/parkinson-s...ably-post.html