Re: Sinemet Startup Questions

[Charles Barasch <CHARANDRANNA@xxxxxxxxxx>]

             I haven't had much time to write during the past month, but
         I've been keeping up with the list, and have been meaning to
         answer the questions about sinemet posed by Lisa Carper and
         and Mike Salter.  I know everyone has a somewhat difference
         experience with sinemet, but I'll give you mine.

             Like Lisa's husband, I'm 45 years old, in an early stage
         of Parkinson's.  I was diagnosed 2 1/2 years ago, although I
         think I've had it for a number of years.  The disease
         effects mostly my left side, and the symptoms are mainly mild
         tremor, lack of armswing, and footdragging.  I find that slow
         movements are most affected; for example, walking is more
         difficult than running, and I'm terribly slow at something
         like dealing cards.

             I resisted sinemet at first, and just took eldepryl, but
         started sinemet about 4 months ago.  At first my side effects
         were nausea and an acrid smell (not a smell from me, but a
         "smell" picked up by my nose that was probably either from
         the breakdown products of the sinemet or a hallucination).

             Both of these side effects went away after about a month.
         The nausea stopped after I began taking the sinemet about
         half an hour before eating.

             Then I started getting a different side effect --
         dyskinesia.  I seemed to have "stylized" extra movements; at
         first I thought I'd picked up a jaunty affectation for some
         reason, but then I realized it only happened shortly after
         taking the sinemet, and it did not happen at all the days I
         didn't take the medication.  (My neurologist recommended
         "drug holidays" Wednesdays and Sundays.)

             I don't like the dyskinesia, but otherwise I like the
         effect of the sinemet.  The basic thing I like is the
         perkiness it gives me -- everyone says I look better, and I
         think it's because I've lost my "mask-like" expression.
         Unfortunately, I think the dyskinesia made me a little too
         "perky," and just last week I cut back on my dose.

             I was taking 25/100 3X/day; I'm now trying 1/2 tablet
         3X/day.  I think I like this better -- I'm not quite as loose
         as I was on a full tablet, but I feel more natural overall,
         and there's only little dyskinesia.

             I try not to eat much dairy or other protein after
         taking the medication.  But I wouldn't worry too much about
         muffins made with milk -- it depends on how much protein there
         is in the muffin overall.

             As for Mike's question about sleep, I think sinemet has
         helped me sleep, maybe not from any specific action of the
         drug, but because I'm more relaxed -- I'm not "fighting" the
         Parkinson's as much during the day.

             In any case, I'd recommend that Lisa's husband and Mike's
         mother try the sinemet.  It's made me a lot more comfortable.

             By the way, a lot of questions about sinemet are answered
         in the "Young Parkinson's Handbook," published this year by
         the American Parkinson Disease Association (800-223-2732).
         I've found this the best overall reference available on all
         aspects of Parkinson's, and probably not just for young
         PDers.

         Charlie Barasch
         Plainfield, VT