Re: possible levodopa overdose, steve

[janet paterson <paterson@xxxxxx>]

my dear cyber-sibling baldwin

i am yet again taking the liberty
of responding to a private post publicly;
i hope you don't mind [i've edited out the silly bits!!]
but i think this kind of discussion is important and appropriate
for the whole list-family to share in and comment on

>Your analysis of the results of Steve's
>taking levodopa is right on the mark.
>Carbi/levo-dopa does cause nausea at first.
>Also, the lack of improvement in symptoms
>may be due to the levodopa.
>Six hundred milligrams sounds like too much.
>I have one question about that, which may
>also relate to my own response to levodopa:
>Can levodopa overdose directly cause "less  mobility" ?
>When I awaken in the morning ...
>I feel relatively good and can move relatively well.
>This evidently is not unusual for parkies.

yep!
i think that's known as the 'sleep benefit'
i.e. we can build up a teeny reserve of dopamine while we are asleep
and i believe the symptoms also subside while we are asleep

sometimes i can walk as soon as i wake up, med-free,
and sometimes i can only shuffle
i think it varies in each individual [same old story!]

>Right away, I take a 25/100 mg carbi/levo-dopa pill.
>About 10 to 15 minutes later,  I suddenly become very slow.
>Sometimes I almost can not move the mouse, my feet cramp,
>I take tiny steps when I walk, and I feel bad.  Could
>this be due to the levodopa?

could be, but i would tend to think
it's simply the 'sleep benefit' running out of steam
i doubt that you would see any benefit from regular sinemet in 10 minutes
particularly as the first dose of the day

>About 1 or 1-1/4 hour after I take the pill I have dyskinesia ..
>A few minutes later I can move easily and I feel relatively good.

sounds to me like you're hitting a 'peak dose' dyskinesia here

>I tried taking 1/2 and even 1/4 of a pill at the first,
>following it with the rest of the pill later
>and still had the dyskinesia - just later.

how soon after the first half would you take the second half of the pill?
maybe they were too close together?

when i did my own mini analysis, based on brian collins' charts
i rated my symptoms every half hour
and noted my med and food intake in detail
on a steno pad that i kept with me constantly
over a period of about five days
[and still do it once in awhile]

that's how i arrived at a relatively smooth [for me]
level of sinemet by taking half a 10/100 pill
every 90 minutes

every 60 minutes was too close and i dysk-oed all over the place
every 120 minutes was too far and i 'kicked out' into my statue imitation

>My stomach is empty when I take the pill, and I take it with water.

interesting
somewhere in my archyology i found a study that said
taking sinemet with something sweet aided in its absorption
something to do with the resulting insulin production

i believe other siblings have noticed this benefit, too
[joyce tames?]

so i always make a point of taking my sinemet with orange juice
or a non-diet soda, or sweetened iced tea, etc

i tend to suspect that this small amount of carbohydrate also
prevents potential stomach upset from the levodopa
which i can still suffer from
although to a much lesser degree than
when i was a newbie at this game

the medical literature describes
the first few years on sinemet as 'the honeymoon period'
where one usually isn't troubled by the 'on/off' phenomenon

however, i suppose as in any life-long union
once the honeymoon is over
the real work starts!


your cyber-sibling in tweaking and adjusting

janet

janet paterson - 50/9 - sinemet/selegiline/prozac - paterson@xxxxxx