Re: Comtan Re: Symptoms

[patandpaula <patandpaulas@xxxxxxxxx>]

charlotte, thanks a lot     paula
----- Original Message -----
From: "charlotte A mancuso" <mancann@xxxxxxxx>
To: <PARKINSN@xxxxxxxxxxxxxxxxxxxx>
Sent: Wednesday, June 26, 2002 1:34 PM
Subject: Comtan Re: Symptoms


> Hi Paula,
>
> Comtan acts the way Tasmar does, but it does not have the precautions
> regarding the liver. It's excreted through the kidneys.  It does nothing
> on its own; it enhances Sinemet by inhibiting COMT, which metabolized
> Sinemet, I believe in the peripheral blood stream, and therefore lessens
> the Sinemet to the brain.  From PubMed, Medline: "...The COMT inhibitors
> entacapone (Comtan) and  tolcapone (Tasmar) dose-dependently inhibit the
> formation of the major metabolite of levodopa, 3-O-methyldopa, and
> improve the bioavailability and reduce the clearance of levodopa without
> significantly affecting its absorption. They are useful adjuncts to
> levodopa in patients with end-of-dose fluctuations. ..."
>
> I hope this helps.
>
> Charlotte
>
>
> On Wed, 26 Jun 2002 08:57:43 -0500 patandpaula <patandpaulas@xxxxxxxxx>
> writes:
> > charlotte, what is comtan??     thanks  paula
> > ----- Original Message -----
> > From: "charlotte A mancuso" <mancann@xxxxxxxx>
> > To: <PARKINSN@xxxxxxxxxxxxxxxxxxxx>
> > Sent: Wednesday, June 26, 2002 2:27 AM
> > Subject: Re: Symptoms
> >
> >
> > > George/Scott,
> > >
> > > It's none of my business, and I'm jumping into the middle of a
> > thread,
> > > but I can't help commenting on the dosages I'm reading for Requip
> > > especially (for what it's worth).
> > >
> > > According to my Movement Disorder Specialist, and everything I've
> > heard
> > > and read about Requip, 6mg of Requip is just about the very least
> > you can
> > > take for a therapeutic effect.  Now I suppose that some people may
> > have
> > > had a beneficial effect with 4 or 5, but 6-7mg/day is considered
> > the
> > > start of a therapeutic dose for Requip.  You can go up to 24
> > mg/day,
> > > although that is the max.
> > >
> > > Incidentally, the dosing is very different from Mirapex, which, mg
> > for
> > > mg, is much more potent.  I started with Mirapex, and found it
> > harder to
> > > take than Requip, and found that after trying for months, I
> > couldn't get
> > > past 1 1/2 mg/day--1/2, 3 times per day.  My doctor had me switch
> > to 7mg
> > > of Requip after a short titration, and I found that, yes indeed, 7
> > mg was
> > > just about the equivalent of 1 1/2 mg of Mirapex.  The max for
> > Mirapex
> > > is, I believe, around 6 mg.
> > >
> > > Also, most people take 25/100, rather than 50/200, although you
> > are
> > > taking extended release.  Extended release doesn't work real well
> > for a
> > > lot of people.  Have you tried regular Sinemet with Comtan?
> > >
> > > I hope you don't mind my little opinions and ideas.  Good luck to
> > you
> > > both.
> > >
> > > Charlotte Mancuso
> > >
> > > On Tue, 25 Jun 2002 23:13:50 -0700 scott burnett
> > <sburnett001@xxxxxxxxx>
> > > writes:
> > > > george,
> > > >         Your situation sounds similar to mine.  Same time
> > schedule,
> > > > similar
> > > > problems but add on neck and back pain, fatigue and a feeling of
> > > > "not being
> > > > right" when I'm off.  I recently upped my dosage of requip to 6
> > mg a
> > > > day
> > > > and that helped some.  Stress really makes a difference  to me
> > so
> > > > the issue
> > > > of continued work is of real concern.  I am changing to what I
> > hope
> > > > is a
> > > > much less stressful position next school year so I evaluate that
> > as
> > > > time
> > > > goes on.  I spent several weeks looking into the California
> > State
> > > > Teachers
> > > > Retirement systems disability set up aand it looks pretty good.
> > > > Even
> > > > though I intend to keep working and adapting my schedule and
> > > > workload as
> > > > much as I'm allowed, it made me feel alot better to have the
> > info at
> > > > hand.
> > > >    Someone from the list put it very well I thought when they
> > wrote,
> > > > "I have
> > > > a cup of energy to use each day, and I have to decide where I
> > want
> > > > to use
> > > > it; at work, with friends or with family."  That's not an exact
> > > > quote but
> > > > you get the point.  Somewhere down the road, all of us PWP's
> > will
> > > > have to
> > > > make a personal choice.  When and where it will be is up to us.
> > > > Scott from California
> > > >
> > > >
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