Optimize Levodopa Therapy

mayoclinicproceedings.org/a...

[Fed1000]

Thanks for sharing, always useful. How it goes with B1?

[Hidden in reply to Fed1000]

Still adjusting. Back on 4g daily

[WinnieThePoo in reply to Hidden]

Roy. I'm interested in this dosage adjustment area. What made you decide the need? Can you summarise the benefits you expect from optimum B1, and how that has now changed?

[Hidden in reply to WinnieThePoo]

Last nite, two dropper full of THC. Slept w/o tremor 11pm to 7am.

[johntPM]

Good tips from the doctor. I think there is a place for more, but smaller doses. This reduces the variation of levodopa levels. High variations are thought to increase the chance of levodopa induced dyskinesia.

[Hidden]

Thank you! Excellent article and easily understood by the layperson. I especially like the reference to starting C/L treatment right away at the optimum dose, which allows the PWP to immediately get into an exercise routine--perhaps the only clinically proven form of halting/slowing the Parkinson's we know of, to date. His mantra is basically: use it, or lose it.

I will be ordering his book on how to team up with the Primary Care Physician (footnote 25). The whole premise of this methodology seems like the 12-step slogan, KISS: Keep It Simple, Stupid.

[condor39]

A GREAT ARTICLE>

This should be required reading for all members of this group.

What I find a bit depressing is that few people will read this, whereas an article on “How I cured why PD with Rhubarb” will get way more readers.

[johntPM in reply to condor39]

I take your point. But, the choice of rhubarb was, perhaps, unfortunate. It is used in traditional Chinese medicine for PD!

See:

frontiersin.org/articles/10...

[condor39 in reply to johntPM]

You are right, but it is impossible to find a substance which has never been promoted.

[Gioc in reply to condor39]

Strange that a sea dog like you doesn't understand the strength that a dream can have. Dreams are the hope for a better life, they are often dreamed by artists, inventors, explorers, thanks to their dreams we have a life outside the cave.

[condor39 in reply to Gioc]

The strength of self-delusion and false-hope?

[Gioc in reply to condor39]

LOL

but what?

What happened to the dreams you had when you were a kid?

Imagine a cure... just one, like a vaccine, like an antiduct to a poison, like you want... you can do it better than me.

IIMO If you can't imagine it, you can't have it...:

[Zella23]

Thanks Roy, very interesting article about dosing. It helps to know all about taking C/L and dyskinesia.

On another note he has just been prescribed Terazozin and starts tonight. Will see how it goes but hopefully positive.

[TheLordsWeapon]

HAPPY THANKSGIVING!

And ..thank you Sir, God Bless!

[Doohat]

The author seems to advocate the use of immediate-release carbidopa/levedopa which surprised me. I thought the controlled-release version was better (more stable, longer lasting, less ups and downs). Didn't know it had "less bioavailability". Interesting article! Thanks for sharing.

[johntPM in reply to Doohat]

Some people find that CR levodopa works better for them. But others find that the lack of control is a problem. Most CR and ER formulations use an enteric coating (or coatings) to slow the disintegration of the active ingredients in the stomach. You can never be sure how long this will take, or when gastric emptying will occur. The extra time that CR spends in the stomach compared to IR, leads to more of it being destroyed before it can do some good.

[Gioc in reply to johntPM]

very true, I had to suspend the extended-release madopar during the day for no control, to use it only once before sleeping.

I stopped writing my dose of madopar which was a combination of the two types because it was misunderstood as the sum of the overall madopar when the bioavailability is very different.

[AmmieM]

Thank you

[serg]

Just forget that you have PD And take you meds do excersise a be in a diaite

[bbc680]

Good info for sure. I find it interesting that when I went to Mayo in Phoenix they immediately wrote me scrips for agonists and told we wanted to save carbidopa for later to hold off the dyskinesia. A few days later I went to Barrow in Phoenix where I was put on Sinemet. Just find it interesting that the Mayo doc went completely against the recos in this article (which came from Mayo).

[James4K]

Thanks Roy, that is one of the best articles that I have read on levodopa

[Nitro53]

Can’t find the article